BLOOD COMPONENTS Storage of volume-reduced washed platelets in M-sol additive solution for 7 days Junichi Hirayama,1 Mitsuhiro Fujihara,1 Mitsuaki Akino,1 Shunsuke Kojima,2 Ryu Yanagisawa,2 Chihiro Homma,1 Toshiaki Kato,1 Hisami Ikeda,1 Hiroshi Azuma,3 Shigetaka Shimodaira,2 and Shigeru Takamoto1
BACKGROUND: Volume-reduced washed platelets (VR-wPLTs), which are prepared by concentrating platelets (PLTs) into a smaller volume of additive solution (AS), may prevent not only circulatory overload, but also adverse reactions caused by plasma components. Although VR-wPLTs may be quickly degraded due to high PLT concentrations, few studies have examined the effects of storage on VR-wPLTs. We examined here the in vitro properties of VR-wPLTs prepared with M-sol AS during their storage for 7 days. STUDY DESIGN AND METHODS: Platelet concentrates (PCs) were divided into two equal aliquots (control group and test group). After the centrifugation of both aliquots and removal of as much supernatant as possible, the pellet of the control group was resuspended in 160 mL of M-sol while that of the test group was resuspended in 80 or 40 mL of M-sol. The wPLTs of both groups were stored in polyolefin bags with agitation at 20 to 24°C for 7 days. RESULTS: The pH values of both groups were maintained at higher than 7.0 during the 7-day storage. Differences in %disk, CD62P, annexin V, percent hypotonic shock response, and aggregation values between the test group and control group were small for at least 2 days after washing. CONCLUSIONS: The in vitro properties of VR-wPLTs were not markedly degraded for at least 2 days. Therefore, the storage properties of PLTs may be maintained in VR-wPLTs prepared at blood centers until they are administered to patients in hospitals.
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latelet concentrates (PCs), which are mostly supplied from the Japanese Red Cross, contain 2 × 1011 to 3 × 1011 platelets (PLTs) suspended in a volume of 160 to 240 mL. This relatively high volume is needed to maintain the functions of PLTs in PCs for 4 days (shelf life). Storage can be compromised at higher PLT concentrations because large numbers of PLTs produce an excess of lactate, which decreases pH, leading to the deterioration of PLTs.1 However, a volume reduction in PCs is sometimes required in clinical settings for infants and patients, who have a limited capacity to compensate for circulatory overload.2-4 Previous studies have examined the clinical use of volume-reduced PCs (VR-PCs), which is prepared by removing excess supernatant after the centrifugation of PCs.3-7 Furthermore, VR-PCs may reduce the incidence of adverse reactions such as anaphylaxis and febrile nonhemolytic reactions.8,9 Washed PLTs (wPLTs) have successfully been used in patients who have repeatedly developed adverse reactions caused by plasma components.10-13 wPLTs, which are
ABBREVIATIONS: HSR = hypotonic shock response; MPV = mean platelet volume; PC(s) = platelet concentrate(s); VR-PC(s) = volume-reduced platelet concentrate(s); VR-wPLTs = volume-reduced washed platelets; VR-wPLTs-2 (-4) = VR-wPLTs concentrated twofold (fourfold); wPLTs = washed platelets. From the 1Japanese Red Cross Hokkaido Block Blood Center, Sapporo, Japan; the 2Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan; and the 3Department of Pediatrics, Asahikawa Medical University School of Medicine, Asahikawa, Japan. Address reprint requests to: Junichi Hirayama, PhD, Nijuyonken 2-1, Nishi-ku, Sapporo 063-0802, Japan; e-mail: [email protected]. Received for publication January 21, 2014; revision received April 7, 2014, and accepted April 9, 2014. doi: 10.1111/trf.12724 © 2014 AABB TRANSFUSION 2014;54:3173-3177. Volume 54, December 2014 TRANSFUSION
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prepared by substituting almost all plasma in PCs with additive solution (AS), are considered to be more effective for reducing these reactions than VR-PCs because the residual plasma volumes in wPLTs prepared in our blood center are less than 12 mL (typically
BACKGROUND: Volume-reduced washed platelets (VR-wPLTs), which are prepared by concentrating platelets (PLTs) into a smaller volume of additive solution (AS), may prevent not only circulatory overload, but also adverse reactions caused by plasma components. Although VR-wPLTs may be quickly degraded due to high PLT concentrations, few studies have examined the effects of storage on VR-wPLTs. We examined here the in vitro properties of VR-wPLTs prepared with M-sol AS during their storage for 7 days. STUDY DESIGN AND METHODS: Platelet concentrates (PCs) were divided into two equal aliquots (control group and test group). After the centrifugation of both aliquots and removal of as much supernatant as possible, the pellet of the control group was resuspended in 160 mL of M-sol while that of the test group was resuspended in 80 or 40 mL of M-sol. The wPLTs of both groups were stored in polyolefin bags with agitation at 20 to 24°C for 7 days. RESULTS: The pH values of both groups were maintained at higher than 7.0 during the 7-day storage. Differences in %disk, CD62P, annexin V, percent hypotonic shock response, and aggregation values between the test group and control group were small for at least 2 days after washing. CONCLUSIONS: The in vitro properties of VR-wPLTs were not markedly degraded for at least 2 days. Therefore, the storage properties of PLTs may be maintained in VR-wPLTs prepared at blood centers until they are administered to patients in hospitals.
P
latelet concentrates (PCs), which are mostly supplied from the Japanese Red Cross, contain 2 × 1011 to 3 × 1011 platelets (PLTs) suspended in a volume of 160 to 240 mL. This relatively high volume is needed to maintain the functions of PLTs in PCs for 4 days (shelf life). Storage can be compromised at higher PLT concentrations because large numbers of PLTs produce an excess of lactate, which decreases pH, leading to the deterioration of PLTs.1 However, a volume reduction in PCs is sometimes required in clinical settings for infants and patients, who have a limited capacity to compensate for circulatory overload.2-4 Previous studies have examined the clinical use of volume-reduced PCs (VR-PCs), which is prepared by removing excess supernatant after the centrifugation of PCs.3-7 Furthermore, VR-PCs may reduce the incidence of adverse reactions such as anaphylaxis and febrile nonhemolytic reactions.8,9 Washed PLTs (wPLTs) have successfully been used in patients who have repeatedly developed adverse reactions caused by plasma components.10-13 wPLTs, which are
ABBREVIATIONS: HSR = hypotonic shock response; MPV = mean platelet volume; PC(s) = platelet concentrate(s); VR-PC(s) = volume-reduced platelet concentrate(s); VR-wPLTs = volume-reduced washed platelets; VR-wPLTs-2 (-4) = VR-wPLTs concentrated twofold (fourfold); wPLTs = washed platelets. From the 1Japanese Red Cross Hokkaido Block Blood Center, Sapporo, Japan; the 2Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan; and the 3Department of Pediatrics, Asahikawa Medical University School of Medicine, Asahikawa, Japan. Address reprint requests to: Junichi Hirayama, PhD, Nijuyonken 2-1, Nishi-ku, Sapporo 063-0802, Japan; e-mail: [email protected]. Received for publication January 21, 2014; revision received April 7, 2014, and accepted April 9, 2014. doi: 10.1111/trf.12724 © 2014 AABB TRANSFUSION 2014;54:3173-3177. Volume 54, December 2014 TRANSFUSION
3173
HIRAYAMA ET AL.
prepared by substituting almost all plasma in PCs with additive solution (AS), are considered to be more effective for reducing these reactions than VR-PCs because the residual plasma volumes in wPLTs prepared in our blood center are less than 12 mL (typically
