Optimizing Platelet Transfusion for Clinical Practice. Do Platelets’s Age Matter for Therapeutic Platelets Transfusion?
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- Category: Vol. 91, December 2023
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Optimizing Platelet Transfusion for Clinical Practice. Do Platelets’s Age Matter for Therapeutic Platelets Transfusion?, MOHAMMED SHARIF, BARAA NOORWALI, FOUAD AL ZAHRANI, AHMED SALAMI, TAHANI AL ZAHRANI, ZAINAH BUKHARI, WAFA AL ANAZZI, HAWAZEN SULIMAN, MAJED ALGARNI, OSAMA AL ZAHARNI, SAMAH MOKHLIS, AMANI GUSTI and SAMY ATTALLAH
Abstract
Background: Platelet concentrates (PCs) with the imple-mentation of bacterial testing have a storage period of 7 days. It was reported that platelet function decreased gradually in vitro until the 5th or 7th day of storage. Pooled PCs (PPCs) are main-ly used in Europe and Canada and there is the possibility to use many PPCs with 7 days storage for transfusion in case of bleeding or massive transfusion. Aim of Study: The aim of this study is to test in vitro both storage conditions and function of platelet-rich plasma (PRP-PCs) during storage for 7 days to assess the function of the PCs for the possibility to extend the use of stored PCs up to 7 days and its use for therapeutic and massive platelets transfusion. Patients and Methods: In this study 18 PRP-PCs, were evaluated for chemical analysis by measuring pH, LDH pro-duction, and glucose consumption levels and platelet aggre-gation testing using adenosine diphosphate (ADP), collagen (COLL), and ristocetin (RIST) and epinephrine (EPI) on days 1,3,5, and 7 of storage of PCs. Results: The platelets yield was >5.58 x 1010 which indi-cates accurate platelet separation and storage. The metabolic parameters indicated stable storage conditions throughout the 7-day period. The chemical analysis showed that there is stable pH during all days of storage above 6.4. Aggregation respons-es of the PCs decreased gradually and significantly (p<0.001) starting from 1st day when compared with 3rd, 5th and 7th day. On the 7th day the platelets lost their response to EPI and ADP, while still maintaining a normal response to RIST and weak to COLL. Conclusion: There is a loss of some function on the 6-7th day of platelet storage which may indicate that it is suitable for prophylactic more than therapeutic transfusion. In order to provide more clinical benefit to the patients with thrombocytopen-ic bleeding, the platelets should be less than 7 days of storage.