Johnson Lacey, Roan Christopher, Lei Pearl, Marks Denese C
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.
Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia.
Vox Sang. 2025 Jun 18. doi: 10.1111/vox.70064.
Cold-stored platelets (CSP) are being used more widely for the treatment of bleeding because of their longer shelf life. However, storage at low temperatures can induce the formation of platelet aggregates. We aimed to study the impact of aggregate formation on platelet quality and function.
Apheresis platelets (40% plasma/60% platelet additive solution [PAS-E]) were refrigerated (2-6°C) for 21 days. CSP that developed aggregates (n = 44) were compared with CSP with no aggregates (controls; n = 45). A subset of aggregated CSP (n = 15) was tested before and after being passed through a transfusion administration set containing a 200-μm filter. Donor- and collection-related parameters and in vitro quality parameters were assessed.
Aggregates were identified in 10.9% of CSP, primarily being found following extended storage (median: 16 days). The platelet count was not different between the aggregated (928 ± 158 × 10/L) and control (931 ± 136 × 10/L; p = 0.920) components at day 21. The pH of aggregated components was lower, and the platelets in aggregated components displayed a greater loss of GPIbα, externalization of CD62P and annexin-V, release of extracellular vesicles and degranulation, compared to controls. Functionally, aggregated CSP had potentiated aggregation responses but reduced clot strength (thromboelastography maximum amplitude [TEG MA]) compared to controls. Filtration reduced aggregates in CSP but retained the platelet count and functional properties. Donor-related factors did not correlate with aggregate formation, although certain collection parameters may be implicated.
Platelets within components that contained aggregates were more activated than non-aggregated controls. The propensity for aggregate formation should be considered when selecting a shelf life for CSP.
由于冷存血小板（CSP）的保质期更长，其在出血治疗中的应用越来越广泛。然而，低温储存会诱导血小板聚集体的形成。我们旨在研究聚集体形成对血小板质量和功能的影响。
单采血小板（40%血浆/60%血小板添加剂溶液[PAS-E]）在2-6°C下冷藏21天。将形成聚集体的CSP（n = 44）与未形成聚集体的CSP（对照组；n = 45）进行比较。对一部分形成聚集体的CSP（n = 15）在通过含有200μm滤器的输血器前后进行检测。评估供体和采集相关参数以及体外质量参数。
在10.9%的CSP中发现了聚集体，主要在延长储存后（中位数：16天）出现。在第21天，形成聚集体的组分（928±158×10⁹/L）和对照组（931±136×10⁹/L；p = 0.920）的血小板计数没有差异。与对照组相比，形成聚集体的组分的pH值较低，且形成聚集体的组分中的血小板显示出糖蛋白Ibα的损失更大、CD62P和膜联蛋白-V的外化、细胞外囊泡的释放和脱颗粒。在功能上，与对照组相比，形成聚集体的CSP具有增强的聚集反应但凝血强度降低（血栓弹力图最大振幅[TEG MA]）。过滤减少了CSP中的聚集体，但保留了血小板计数和功能特性。供体相关因素与聚集体形成无关，尽管某些采集参数可能与之有关。
含有聚集体的组分中的血小板比未聚集的对照组更易激活。在选择CSP的保质期时应考虑聚集体形成的倾向。
