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A Prospective Observational Study To Compare Transfusion Outcomes In Abo Identical Versus Abo Non-Identical Single Donor Platelet Concentrates: An Experience From A Tertiary Healthcare Center In India. Transfus Clin Biol 2022; 29:213-218. [PMID: 35667592 DOI: 10.1016/j.tracli.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
ABO incompatible single donor platelet concentrates (SDPC) have a concern about unsatisfactory increments as well as possibility of hemolytic transfusion reaction. But from Indian population no study has commented on the clinical and laboratory outcome of ABO mismatched platelet transfusion. The aim of study was to compare transfusion outcomes in ABO identical versus ABO non-identical single donor platelet concentrates. In this prospective observational study, 400 SDPC transfusions among different patients were included. In group A (n = 200), ABO identical SDPC transfusions and in group B (n = 200) ABO non-identical SDPC transfusions were added. Corrective count increment (CCI), absolute count increment (ACI), percent platelet recovery (PPR) were calculated and incidents of hemolytic transfusion reactions were noted. In group A mean ± SD of ACI, CCI and PPR were as 30.78 ± 12.51, 15.10 ± 6.677, 39948.9 ± 20099.392. In group B, mean ± SD of ACI, CCI and PPR were - 25.4 ± 15.65, 12.509 ± 5.906, 33559.2 ± 22150.304. And when CCI, ACI, PPR were compared with group A and group B, statistically significant differences were noted (p <0.05). There was statistically significant difference in CCI, ACI and PPR in oncology patients and other prophylactic recipients except patients with dengue and other infectious disease. But there was no hemolytic transfusion reaction noted in any group. Our study clearly establish the potential benefits of ABO-identical PLT transfusion. It also points out that in emergency conditions or when there is a paucity in inventory, ABO non-identical SDPC transfusion may be lifesaving and clinically significant.
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Liker M, Bojanić I, Plenković F, Lukić M, Tomac G, Raos M, Ćepulić BG. Platelet transfusion practice and related transfusion reactions in a large teaching hospital. Transfus Clin Biol 2021; 29:37-43. [PMID: 34411746 DOI: 10.1016/j.tracli.2021.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/07/2021] [Accepted: 08/12/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Platelet transfusion practice varies widely since many aspects of platelet concentrate (PC) use have not been definitively determined. The objectives of this retrospective study were to present platelet transfusion practice and evaluate PC and patient characteristics, as well as their association with transfusion reaction (TR) rate. MATERIAL AND METHODS Platelet transfusions over a 5-year period were analysed regarding PC characteristics (the ABO and RhD compatibility, product type, and storage duration), patient characteristics (most responsible diagnosis, age, and gender), and TR type. RESULTS A total of 46,351 PCs were transfused: 76.4% whole blood-derived (WBD) and 23.6% single donor apheresis (SDA). Three thousand seven hundred seventy-six patients received platelet transfusions: 24.7% paediatric and 75.3% adult patients, 79.6% outpatients and 20.4% inpatients. As much as 63.1% of all transfused PCs were fresh (stored for≤3 days), 98.0% ABO-identical, and 87.3% of all PCs given to RhD- patients were RhD-. PCs were mainly transfused to haemato-oncology (76.8%) and cardiovascular surgery patients (6.5%). Overall, 84 (0.18%) TRs were reported, with allergic TRs (ATRs) being the most common. Although PC ABO compatibility and storage duration, as well as patient age and gender, showed differences in TR rate, only the use of PCs in platelet additive solution (PAS) showed a statistically significant reduction of TRs (P<0.001). CONCLUSION Transfusion practice at the University Hospital Centre Zagreb resulted in almost all patients receiving ABO and RhD identical PCs, and most of them were fresh PCs. The most important factor affecting the incidence of TRs was platelet storage solution. The use of PAS effectively reduced the rate of TRs, particularly allergic TRs.
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Affiliation(s)
- M Liker
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia.
| | - I Bojanić
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia; School of Medicine, University of Zagreb, Croatia
| | - F Plenković
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
| | - M Lukić
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
| | - G Tomac
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
| | - M Raos
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia
| | - B G Ćepulić
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia; School of Medicine, University of Zagreb, Croatia; Department of Health Studies, University of Split, Croatia
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3
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Hayashi T, Hayashi A, Fujimura Y, Masaki M, Kishikawa T, Sakaguchi H, Tanaka M, Kimura T, Tani Y, Takihara Y, Hirayama F. Dual preparation of plasma and platelet concentrates in platelet additive solution from platelet concentrates in plasma using a novel filtration system. Vox Sang 2021; 117:49-57. [PMID: 34082471 DOI: 10.1111/vox.13155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/06/2021] [Accepted: 05/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Platelet concentrates suspended in a platelet additive solution (PAS-PC) are associated with a reduction in allergic response and are suitable for preparing pathogen-inactivated PC. We aimed to develop an efficient platform for the dual preparation of PAS-PC and platelet-poor plasma. MATERIALS AND METHODS PAS-PC was prepared in six steps by using a hollow-fibre system based on cross-flow filtration: priming, loading PC, loading PAS, collection of filtered liquid (flow-through) and collection of platelets by washing with PAS followed by washing with air. In this study, the efficacy of platelet and plasma protein recovery and characteristics of recovered PAS-PC and flow-through plasma were analysed in detail. RESULTS Recoveries of platelet in PAS-PC and plasma protein in the flow-through were 95.4% ± 3.7% and 61.6% ± 5.0%, respectively. The residual plasma protein in PAS-PC was 34.1% ± 2.8%. Although the expression level of CD62P, a platelet activation marker, in recovered platelets was approximately 1.2-fold of that in original platelets, swirling patterns were well retained, and aggregation in PAS-PC was not visible. Agonist-induced aggregabilities, platelet morphology and hypotonic shock recovery were conserved. The patterns of plasma protein and lipoprotein in the flow-through were comparable with those in the original PCs. The multimeric pattern analysis of VWF remained unaltered. CONCLUSION We propose a highly efficient preparation system that enables the simultaneous production of PAS-PC and platelet-poor plasma. It also achieves a high recovery of functionally well-retained platelets with very low activation.
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Affiliation(s)
- Tomoya Hayashi
- Japanese Red Cross Kinki Block Blood Centre, Ibaraki, Japan
| | - Akihiro Hayashi
- Advanced Materials Research Laboratories, Toray Industries, Inc., Otsu, Japan
| | | | - Mikako Masaki
- Japanese Red Cross Kinki Block Blood Centre, Ibaraki, Japan
| | - Tatsuya Kishikawa
- Advanced Materials Research Laboratories, Toray Industries, Inc., Otsu, Japan
| | - Hirokazu Sakaguchi
- Advanced Materials Research Laboratories, Toray Industries, Inc., Otsu, Japan
| | | | | | - Yoshihiko Tani
- Central Blood Institute, Japanese Red Cross, Tokyo, Japan
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Rajadhyaksha BS, Desai DP, Navkudkar AA. Platelet refractoriness. GLOBAL JOURNAL OF TRANSFUSION MEDICINE 2019. [DOI: 10.4103/gjtm.gjtm_45_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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5
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Jaime-Pérez JC, Vázquez-Hernández KE, Jiménez-Castillo RA, Fernández LT, Salazar-Riojas R, Gómez-Almaguer D. Platelet Survival in Hematology Patients Assessed by the Corrected Count Increment and Other Formulas. Am J Clin Pathol 2018; 150:267-272. [PMID: 29982409 DOI: 10.1093/ajcp/aqy052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To compare the performance of the corrected count increment (CCI) and three other formulas to assess 24-hour posttransfusion platelet survival in hematology patients. METHODS Twenty-four-hour posttransfusion platelet counts were analyzed after apheresis platelet transfusion. Platelet increment (PI), percent platelet recovery (PPR), and percentage platelet increment (PPI) were compared with CCI by receiver operating characteristic analysis. Clinical factors that influence platelet survival were assessed by logistic regression. RESULTS In total, 142 apheresis platelet transfusions in 85 hematology patients were studied. Mean (SD) CCI at 24 hours was 11,869 (10,125). Compared with CCI, the sensitivity of other formulas ranged from 89.4% to 95.7% and specificity from 94.7% to 100%. Cutoff values were 15.7 × 103/µL for PI, 11.4% for PPR, and 17% for PPI. For ABO-compatible vs incompatible transfusions, CCI was 14,070/µL vs 9,176/µL (P = .007). Negative factors for all formulas were sepsis, hypotension, and amphotericin B. CONCLUSIONS PI, PPR, and PPI are comparable to CCI for assessing 24-hour platelet survival.
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Affiliation(s)
- José C Jaime-Pérez
- Department of Hematology, Dr José Eleuterio González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Karina E Vázquez-Hernández
- Department of Hematology, Dr José Eleuterio González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Raúl A Jiménez-Castillo
- Department of Hematology, Dr José Eleuterio González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Lucía T Fernández
- Department of Hematology, Dr José Eleuterio González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Rosario Salazar-Riojas
- Department of Hematology, Dr José Eleuterio González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - David Gómez-Almaguer
- Department of Hematology, Dr José Eleuterio González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
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6
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Gurevich-Shapiro A, Tzadok S, Rosenberg A, Inbal A, Bar-Natan M, Wolach O, Raanani P. Extended Small-Dose Platelet Transfusions in Multitransfused Hemato-Oncological Patients: A Single-Center Experience. Acta Haematol 2017; 137:183-190. [PMID: 28419992 DOI: 10.1159/000465510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 02/26/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Refractoriness to platelet transfusion, prevalent among 15-20% of hemato-oncological patients, is associated with multitransfusions and inferior outcomes. We evaluated the effectiveness of extended slow-dose transfusion (ESDT) in increasing platelet increments in multitransfused patients. METHODS Patients treated after the implementation of ESDT were compared with historical controls treated with standard single-donor platelet (SDP) transfusions. Cohorts of early and late recipients were assembled for comparison, i.e. the 8th or 9th and 11th platelet unit per patient, respectively. Patients in the ESDT group received transfusions equal to half an SDP unit, administered over 4 h. Effectiveness was defined as a higher corrected count increment (CCI) at 1, 12, and 24 h after transfusion. RESULTS In the early-recipients cohort, 24-h-posttransfusion increments were available for 29 ESDT patients and 6 standard patients, and did not differ significantly between the groups (p = 0.078). The 24-h-posttransfusion increment was available for 20 ESDT patients and 7 standard patients in the late-recipients cohort. The CCI was significantly higher in the ESDT group (p = 0.042). ABO compatibility improved the CCI (p = 0.01). CONCLUSIONS ESDT demonstrated slightly higher increments at 24 h after transfusion in late recipients, suggesting this could be a cost-effective approach for the treatment of thrombocytopenic multitransfused hemato-oncological patients.
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Garner SF, Furnell A, Kahan BC, Jones CI, Attwood A, Harrison P, Kelly AM, Goodall AH, Cardigan R, Ouwehand WH. Platelet responses to agonists in a cohort of highly characterised platelet donors are consistent over time. Vox Sang 2016; 112:18-24. [PMID: 28001309 PMCID: PMC5299478 DOI: 10.1111/vox.12468] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 09/16/2016] [Accepted: 09/22/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND OBJECTIVES Platelet function shows significant inheritance that is at least partially genetically controlled. There is also evidence that the platelet response is stable over time, but there are few studies that have assessed consistency of platelet function over months and years. We aimed to measure platelet function in platelet donors over time in individuals selected from a cohort of 956 donors whose platelet function had been previously characterised. MATERIALS AND METHODS Platelet function was assessed by flow cytometry, measuring fibrinogen binding and P-selectin expression after stimulation with either cross-linked collagen-related peptide or adenosine 5'-diphosphate. Eighty-nine donors from the Cambridge Platelet Function Cohort whose platelet responses were initially within the lower or upper decile of reactivity were retested between 4 months and five and a half years later. RESULTS There was moderate-to-high correlation between the initial and repeat platelet function results for all assays (P ≤ 0·007, r2 0·2961-0·7625); furthermore, the range of results observed in the initial low and high responder groups remained significantly different at the time of the second test (P ≤ 0·0005). CONCLUSION Platelet function remains consistent over time. This implies that this potential influence on quality of donated platelet concentrates will remain essentially constant for a given donor.
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Affiliation(s)
- S F Garner
- NHS Blood and Transplant, Cambridge, UK.,Department of Haematology, University of Cambridge, Cambridge, UK
| | - A Furnell
- NHS Blood and Transplant, Cambridge, UK.,Department of Haematology, University of Cambridge, Cambridge, UK
| | - B C Kahan
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - C I Jones
- Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - A Attwood
- NHS Blood and Transplant, Cambridge, UK.,Department of Haematology, University of Cambridge, Cambridge, UK
| | - P Harrison
- Institute of Inflammation and Ageing, Queen Elizabeth Hospital, University of Birmingham, Birmingham, UK
| | - A M Kelly
- NHS Blood and Transplant, Cambridge, UK.,Department of Haematology, University of Cambridge, Cambridge, UK
| | - A H Goodall
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - R Cardigan
- NHS Blood and Transplant, Cambridge, UK.,Department of Haematology, University of Cambridge, Cambridge, UK
| | - W H Ouwehand
- NHS Blood and Transplant, Cambridge, UK.,Department of Haematology, University of Cambridge, Cambridge, UK.,Wellcome Trust Sanger Institute, Cambridge, UK
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8
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Miller VM, Lahr BD, Bailey KR, Heit JA, Harman SM, Jayachandran M. Longitudinal effects of menopausal hormone treatments on platelet characteristics and cell-derived microvesicles. Platelets 2015; 27:32-42. [PMID: 25856160 PMCID: PMC4732432 DOI: 10.3109/09537104.2015.1023273] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Activated platelets serve as a catalyst for thrombin generation and a source of vasoactive and mitogenic factors affecting vascular remodeling. Oral menopausal hormone treatments (MHT) may carry greater thrombotic risk than transdermal products. This study compared effects of oral and transdermal MHT on platelet characteristics, platelet proteins, and platelet-derived microvesicles (MV) in recently menopausal women. Platelets and MV were prepared from blood of a subset of women (n = 117) enrolled in the Kronos Early Estrogen Prevention Study prior to and after 48 months of treatment with either oral conjugated equine estrogen (0.45 mg/day), transdermal 17β-estradiol (50 µg/day), each with intermittent progesterone (200 mg/day for 12 days a month), or placebo pills and patch. Platelet count and expression of platelet P-selectin and fibrinogen receptors were similar across groups. An aggregate measure of 4-year change in vasoactive and mitogenic factors in platelet lysate, by principle component analysis, indicated significantly lower values in both MHT groups compared to placebo. Increases in numbers of tissue factor positive and platelet-derived MV were significantly greater in the transdermal compared to placebo group. MHT was associated with significantly reduced platelet content of vasoactive and mitogenic factors representing a potential mechanism by which MHT may affect vascular remodeling. Various hormonal compositions and doses of MHT could differentially regulate nuclear transcription in bone marrow megakaryocytes and non-genomic pathways in circulating platelets thus determining numbers and characteristics of circulating MV. Thrombotic risk associated with oral MHT most likely involves liver-derived inflammatory/coagulation proteins rather than circulating platelets per se.
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Affiliation(s)
- Virginia M Miller
- a Department of Surgery , College of Medicine, Mayo Clinic , Rochester , MN , USA .,b Department of Physiology & Biomedical Engineering , Mayo Clinic , Rochester , MN , USA
| | - Brian D Lahr
- c Division of Biomedical Statistics and Informatics , Mayo Clinic , Rochester , MN , USA
| | - Kent R Bailey
- c Division of Biomedical Statistics and Informatics , Mayo Clinic , Rochester , MN , USA .,d Division of Epidemiology , Mayo Clinic , Rochester , MN , USA
| | - John A Heit
- e Division of Cardiovascular Diseases , Internal Medicine, Mayo Clinic , Rochester , MN , USA , and
| | - S Mitchell Harman
- f Kronos Longevity Research Institute and Phoenix VA Health Care System , Phoenix , AZ , USA
| | - Muthuvel Jayachandran
- b Department of Physiology & Biomedical Engineering , Mayo Clinic , Rochester , MN , USA
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9
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Ringwald J, Antoon M, Eckstein R, Cardoso M. Residual aggregates in platelet products: what do we know? Vox Sang 2013; 106:209-18. [DOI: 10.1111/vox.12089] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 07/11/2013] [Accepted: 07/18/2013] [Indexed: 11/30/2022]
Affiliation(s)
- J. Ringwald
- Department of Transfusion Medicine and Hemostaseology; University Hospital of Erlangen; Erlangen Germany
| | - M. Antoon
- Terumo BCT Biotechnologies; Zaventem Belgium
| | - R. Eckstein
- Department of Transfusion Medicine and Hemostaseology; University Hospital of Erlangen; Erlangen Germany
| | - M. Cardoso
- Terumo BCT Biotechnologies; Zaventem Belgium
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10
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[Transfusion support of haematological malignancies in 2012: evolution of the recommendations]. Transfus Clin Biol 2012; 19:150-3. [PMID: 23039957 DOI: 10.1016/j.tracli.2012.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 07/21/2012] [Indexed: 11/21/2022]
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11
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Henrichs KF, Howk N, Masel DS, Thayer M, Refaai MA, Kirkley SA, Heal JM, Blumberg N. Providing ABO-identical platelets and cryoprecipitate to (almost) all patients: approach, logistics, and associated decreases in transfusion reaction and red blood cell alloimmunization incidence. Transfusion 2012; 52:635-40. [PMID: 21895675 PMCID: PMC3235249 DOI: 10.1111/j.1537-2995.2011.03329.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND There are multiple benefits to transfusing only ABO-identical blood components. Historically our institution routinely transfused ABO-nonidentical platelets (PLTs) and cryoprecipitate to surgical patients. In April 2005, we implemented a policy of transfusing only ABO-identical components whenever feasible, regardless of outdating or logistic considerations. STUDY DESIGN AND METHODS Technical staff closely monitored product usage and adjusted blood center orders based on recent utilization and planned transfusions. When unable to provide ABO-identical PLTs, ABO-compatible PLTs were washed to remove incompatible plasma. Data on outdating were collected for 18 months before and after implementation. We compared transfusion reaction and red blood cell (RBC) alloimmunization incidence for 4 years preceding (2001-2004) and subsequent (2006-2009) to implementation. RESULTS In the year after implementation, only 11 of 410 surgical patients received ABO-nonidentical PLTs (2.7%). There was a 5.6% increase in outdating of PLTs. Transfusing ABO-identical components was associated with significant reductions in febrile (-46%; 8.0 to 4.3 per 10,000 components; p < 0.0001) and allergic transfusion reactions (-23%; from 7.0 to 5.4 per 10,000 components; p = 0.025). A progressive reduction in de novo RBC alloimmunization incidence also occurred (-50% by 2009; p = 0.03). CONCLUSIONS Providing ABO-identical PLTs to almost all patients was feasible in our setting by changing ordering and inventorying procedures and making the ABO-identical policy a staff priority. Unexpected and striking reductions in febrile and allergic reactions and RBC alloimmunization were observed, of uncertain causal relationship to this ABO policy change, which will require further study.
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Affiliation(s)
- Kelly F Henrichs
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA
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12
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Jayachandran M, Litwiller RD, Lahr BD, Bailey KR, Owen WG, Mulvagh SL, Heit JA, Hodis HN, Harman SM, Miller VM. Alterations in platelet function and cell-derived microvesicles in recently menopausal women: relationship to metabolic syndrome and atherogenic risk. J Cardiovasc Transl Res 2011; 4:811-22. [PMID: 21786187 PMCID: PMC3219869 DOI: 10.1007/s12265-011-9296-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 06/13/2011] [Indexed: 12/31/2022]
Abstract
A woman's risk for metabolic syndrome (MS) increases at menopause, with an associated increase in risk for cardiovascular disease. We hypothesized that early menopause-related changes in platelet activity and concentrations of microvesicles derived from activated blood and vascular cells provide a mechanistic link to the early atherothrombotic process. Thus, platelet functions and cellular origin of blood-borne microvesicles in recently menopausal women (n = 118) enrolled in the Kronos Early Estrogen Prevention Study were correlated with components of MS and noninvasive measures of cardiovascular disease [carotid artery intima medial thickness (CIMT), coronary artery calcium (CAC) score, and endothelial reactive hyperemic index (RHI)]. Specific to individual components of the MS pentad, platelet number increased with increasing waist circumference, and platelet secretion of ATP and expression of P-selectin decreased with increasing blood glucose (p = 0.005) and blood pressure (p < 0.05), respectively. Waist circumference and systolic blood pressure were independently associated with monocyte- and endothelium-derived microvesicles (p < 0.05). Platelet-derived and total procoagulant phosphatidylserine-positive microvesicles, and systolic blood pressure correlated with CIMT (p < 0.05), but not with CAC or RHI. In summary, among recently menopausal women, specific platelet functions and concentrations of circulating activated cell membrane-derived procoagulant microvesicles change with individual components of MS. These cellular changes may explain in part how menopause contributes to MS and, eventually, to cardiovascular disease.
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Affiliation(s)
- Muthuvel Jayachandran
- Department of Physiology & Biomedical Engineering, Mayo Clinic, 200 First St. SW, Rochester, MN 55905 USA
| | - Robert D. Litwiller
- Department of Internal Medicine Division of Hematology, Mayo Clinic, Rochester, MN 55905 USA
| | - Brian D. Lahr
- Department of Health Sciences Research Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905 USA
| | - Kent R. Bailey
- Department of Health Sciences Research Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905 USA
| | - Whyte G. Owen
- Department of Internal Medicine Division of Hematology, Mayo Clinic, Rochester, MN 55905 USA
- Department of Biochemistry & Molecular Biology, Mayo Clinic, Rochester, MN 55905 USA
| | - Sharon L. Mulvagh
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905 USA
| | - John A. Heit
- Department of Internal Medicine Division of Hematology, Mayo Clinic, Rochester, MN 55905 USA
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905 USA
| | - Howard N. Hodis
- Atherosclerosis Research Unit, University of Southern California, Los Angeles, CA 90033 USA
| | | | - Virginia M. Miller
- Department of Physiology & Biomedical Engineering, Mayo Clinic, 200 First St. SW, Rochester, MN 55905 USA
- Department of Surgery, Mayo Clinic, Rochester, MN 55905 USA
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13
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Maurer-Spurej E, Labrie A, Pittendreigh C, Chipperfield K, Smith C, Heddle N, Liu Y, Yi QL, Barnett M. Platelet quality measured with dynamic light scattering correlates with transfusion outcome in hematologic malignancies. Transfusion 2009; 49:2276-84. [DOI: 10.1111/j.1537-2995.2009.02302.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Shehata N, Tinmouth A, Naglie G, Freedman J, Wilson K. ABO-identical versus nonidentical platelet transfusion: a systematic review. Transfusion 2009; 49:2442-53. [DOI: 10.1111/j.1537-2995.2009.02273.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Glycans and glycosylation of platelets: current concepts and implications for transfusion. Curr Opin Hematol 2009; 15:606-11. [PMID: 18832932 DOI: 10.1097/moh.0b013e328313e3bd] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW Platelet products are currently stored at room temperature, because refrigeration causes their rapid clearance from the circulation upon transfusion. Glycans have recently been emphasized as important determinants for the clearance of refrigerated platelets. The present review addresses the current knowledge of platelet glycans and the potential of glycosylation for improving platelet storage. RECENT FINDINGS Removal of refrigerated platelets from the circulation is partly mediated by recognition of clustered beta-N-acetylglucosamine on platelet surface glycoproteins by the alphaMbeta2 hepatic lectin receptor. Capping the exposed beta-N-acetylglucosamine residues by enzymatic galactosylation restored the circulation of short-term chilled murine platelets, introducing a novel method that allows for cold storage of platelet. Recent studies have, however, shown that galactosylation is not sufficient to restore circulation of long-term refrigerated platelets. Additional data indicate that differential carbohydrate-mediated mechanisms may exist for clearance of short-term and long-term cold-stored platelets. SUMMARY Room temperature storage of platelet products increases the risk of transfusion-mediated sepsis and accelerates platelet deterioration, limiting platelet shelf life. Recent evidence suggests that glycoengineering of platelets might allow for their cold storage, significantly improving the quality of platelet products.
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Julmy F, Ammann RA, Taleghani BM, Fontana S, Hirt A, Leibundgut K. Transfusion efficacy of ABO major-mismatched platelets (PLTs) in children is inferior to that of ABO-identical PLTs. Transfusion 2009; 49:21-33. [DOI: 10.1111/j.1537-2995.2008.01914.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Cooling LL, Downs TA, Butch SH, Davenport RD. Anti-A and anti-B titers in pooled group O platelets are comparable to apheresis platelets. Transfusion 2008; 48:2106-13. [DOI: 10.1111/j.1537-2995.2008.01814.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Hellstern P. Efficacy and Adverse Events of Platelet Transfusion Product-Specific Differences. Transfus Med Hemother 2008; 35:102-105. [PMID: 21512636 DOI: 10.1159/000119117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Accepted: 01/14/2008] [Indexed: 11/19/2022] Open
Abstract
SUMMARY: TWO PREPARATIONS ARE AVAILABLE FOR PLATELET TRANSFUSION: single-donor apheresis platelet concentrates (APC) and pooled platelet concentrates (PPC) prepared from 4-6 whole blood units. Clear advantages of APC over PPC are a markedly reduced donor exposure of recipients, and easier logistics when attempting a complete supply with ABO-identical and Rh-compatible platelet concentrates. Regulations should aim at complete ABO-identical platelet transfusions because major and minor ABO-incompatible platelet transfusions are probably associated with significantly increased morbidity and mortality. The main advantage of PPC is lower costs. Preparation of PPC is however inevitably accompanied by substantial wastage of plasma and red cells. Only major supraregional blood transfusion centers can guarantee full-coverage supply with ABO-identical and Rh-compatible PPC. Whether APC are more effective than PPC and associated with fewer septic platelet transfusion reactions as shown in some but not all studies, has to be examined in future prospective controlled trials.
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Affiliation(s)
- Peter Hellstern
- Institut für Hämostaseologie und Transfusionsmedizin, Klinikum der Stadt Ludwigshafen, Germany
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19
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Boga C, Ozdogu H, Kozanoglu I, Sozer O, Sezgin N, Kizilkilic E, Bakar C. Platelet P-selectin expression in patients with sickle cell disease who undergo apheresis. Ther Apher Dial 2007; 11:255-61. [PMID: 17661830 DOI: 10.1111/j.1744-9987.2007.00475.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Activated platelets have been identified in patients with sickle cell disease. However, the association of platelet P-selectin expression and automated red cell exchange procedures in these patients is not well known. We hypothesized that altered whole platelet P-selectin expression is associated with automated red cell exchange. Flow cytometric quantification of platelet P-selectin expression was carried out in 23 patients with sickle cell disease before and after automated red cell exchange. P-selectin expression was quantified as a binding index for platelet P-selectin (the percentage of positive platelets multiplied by the mean fluorescence of positive platelets). The patients were divided into two groups: individuals with painful vaso-occlusive crises (four women and five men; group 1) and those in a steady state (six women and eight men; group 2). The 33 exchange procedures were evaluated prospectively and used acid-citrate-dextrose A solution (whole blood to anticoagulant ratio = 14:1). Platelet P-selectin expression did not significantly change after automated red cell exchange. Clinical factors such as the volume of replacement fluid and the citrate infusion rate did not correlate with postapheresis platelet P-selectin expression. In addition, the association of platelet P-selectin expression and automated red cell exchange was independent of other laboratory factors (hematocrit level, hemoglobin S level, platelet count, and nitric oxide level). Finally, the difference between the study groups regarding platelet P-selectin expression before and after apheresis was insignificant. In conclusion, automated red cell exchange procedures do not induce platelet P-selectin expression in patients with sickle cell disease in the steady state or in vaso-occlusive crisis.
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Affiliation(s)
- Can Boga
- Department of Hematology, University of Baskent, Ankara, Turkey.
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20
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Eder AF, Chambers LA. Noninfectious complications of blood transfusion. Arch Pathol Lab Med 2007; 131:708-18. [PMID: 17488156 DOI: 10.5858/2007-131-708-ncobt] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2006] [Indexed: 11/06/2022]
Abstract
CONTEXT Serious noninfectious complications are far more likely to occur than viral disease transmission from blood component transfusion. OBJECTIVE To compile a comprehensive list of the noninfectious risks of transfusion, examples of published risk estimates, and summaries of recent information regarding cause, prevention, or management of noninfectious transfusion risks. DATA SOURCES Information was obtained from peer-reviewed English-language medical journal publications since 1990. CONCLUSIONS Early complications, although potentially more serious, usually occur less frequently (<1 in 1000 transfusions) than late complications, which often affect more than 1% of recipients. Areas of active investigation and discussion include acute hemolytic reactions, transfusion-related acute lung injury, red cell alloimmunization, platelet transfusion refractoriness, and transfusion immunosuppression. Continued effort toward research and education to promote recognition and prevention of noninfectious complications associated with blood components is warranted.
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Affiliation(s)
- Anne F Eder
- Biomedical Headquarters, American Red Cross, Washington, DC, USA
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21
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Grossin E, Chamfly V. [Platelet-washing solution optimization]. Transfus Clin Biol 2005; 12:319-30. [PMID: 16153869 DOI: 10.1016/j.tracli.2005.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2004] [Accepted: 08/04/2005] [Indexed: 11/24/2022]
Abstract
Different washing and homogénéisation solutions are hereby analysed by comparing the evolution of functional indicators during the preservation of washed aphaeresis platelet concentrates: physiological pH 4.5 and 6 solutions, buffered physiological pH 6.8 glucose solution, and two physiological pH 7 citrate solutions with acetate. Prior acidification of platelet concentrates proved to be essential. Two washings with manual or automated technique, guarantee residual proteins at a level of less than 0.5 g. Solutions T-Sol Baxter or SSP Macopharma allow us to obtain a product that meet the PSL specifications. Routine since June 2004, washings are done with a physiological pH 6 solution, then homogeneised with T-Sol solution. Platelet recovery, swirling phenomenon, lack of agrgegates, pH maintenance, low increase in the platelet average volume and maintenance of intra-cell potassium level, suggest that platelet entirety is preserved beyond the product's expiration date. The platelet transfusion yield of these products is satisfactory.
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Affiliation(s)
- E Grossin
- Etablissement de transfusion sanguine Ile-de-France, service préparation des produits sanguins labiles, site de Pontoise
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22
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Universal platelets: “A” change in dogma. Blood 2005. [DOI: 10.1182/blood-2005-01-0289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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23
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Cooling LLW, Kelly K, Barton J, Hwang D, Koerner TAW, Olson JD. Determinants of ABH expression on human blood platelets. Blood 2004; 105:3356-64. [PMID: 15613545 DOI: 10.1182/blood-2004-08-3080] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Platelets express ABH antigens, which can adversely effect platelet transfusion recovery and survival in ABH-incompatible recipients. To date, there has been no large, comprehensive study comparing specific donor factors with ABH expression on platelet membranes and glycoconjugates. We studied ABH expression in 166 group A apheresis platelet donors by flow cytometry, Western blotting, and thin layer chromatography relative to donor age, sex, A1/A2 subgroup, and Lewis phenotype. Overall, A antigen on platelet membranes, glycoproteins, and glycosphingolipids was linked to an A1 red blood cell (RBC) phenotype. Among A1 donors, platelet ABH varied significantly between donors (0%-87%). Intradonor variability, however, was minimal, suggesting that platelet ABH expression is a stable, donor-specific characteristic, with 5% of A1 donors typing as either ABH high- or low-expressers. Group A2 donors, in contrast, possessed a Bombay-like phenotype, lacking both A and H antigens. Unlike RBCs, ABH expression on platelets may be determined primarily by H-glycosyltransferase (FUT1) activity. Identification of A2 and A1 low expressers may increase the availability and selection of crossmatched and HLA-matched platelets. Platelets from group A2 may also be a superior product for patients undergoing A/O major mismatch allogeneic progenitor cell transplantation.
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Affiliation(s)
- Laura L W Cooling
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA.
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24
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Paglieroni TG, Janatpour K, Gosselin R, Crocker V, Dwyre DM, MacKenzie MR, Holland PV, Larkin EC. Platelet function abnormalities in qualified whole-blood donors: effects of medication and recent food intake. Vox Sang 2004; 86:48-53. [PMID: 14984560 DOI: 10.1111/j.0042-9007.2004.00384.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Platelet function abnormalities have been reported in blood donors who have not consumed aspirin. Our objective was to identify factors other than aspirin that may contribute to impaired platelet function in qualified volunteer blood donors. MATERIALS AND METHODS Blood samples were obtained from 24 donors following routine blood donation. Donors completed a study questionnaire that included questions about recent food consumption, medication and medical history. Platelet activation was measured using monoclonal antibodies and flow cytometry. CD62P expression and PAC-1 binding on platelets were used as indicators of platelet activation. Platelet function was measured on a platelet function analyser (PFA-100) using both collagen/epinephrine (cEPI) and collagen/ADP (cADP) cartridges. RESULTS Fifty-four per cent of donors (13 of 24) had normal platelet function. Thirty-eight per cent (nine of 24) had prolonged cEPI closure times, of whom four (17%) had no cEPI closure (> 300 seconds). No closure was associated with aspirin use (two donors) or chocolate consumption (two donors) before donation. Two donors (8%) had either a shortened cEPI or cADP closure time. CONCLUSIONS Platelet dysfunction in qualified blood donors is underestimated. Platelet function screening can identify donors with diet-related platelet dysfunction or with poor recollection of aspirin use.
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Affiliation(s)
- T G Paglieroni
- BloodSource-Center for Blood Research, Sacramento, CA, USA University of California Davis Medical Center, Sacramento, CA, USA.
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25
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AuBuchon JP, Herschel L, Roger J, Murphy S. Preliminary validation of a new standard of efficacy for stored platelets. Transfusion 2004; 44:36-41. [PMID: 14692965 DOI: 10.1046/j.0041-1132.2004.00604.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Platelet preparation and storage systems, unlike those for RBC, lack an objective, absolute performance criterion to determine acceptability. Recently, a criterion based on paired comparison with the radiolabeled recovery and survival of "fresh" platelets has been proposed, namely, recovery = two-thirds and survival = half of "fresh" platelets. STUDY DESIGN AND METHODS Eleven normal subjects donated a unit of leukoreduced apheresis platelets using a standard, approved system. They received an aliquot radiolabeled with 111In or 51Cr (random selection) 4 to 20 hours after donation and, using the other radioisotope, on Day 5 of storage. The recovery was calculated based on the injectate radioactivity. The survival was determined using the multiple-hit model. The area under the platelet survival curve was calculated using the COST program. RESULTS Reinfusion of platelets less than 20 hours after collection resulted in a recovery of 74.7 +/- 12.3 percent and a survival time of 7.5 +/- 1.1 days. Reinfusion on Day 5 resulted in a recovery of 58.2 +/- 12.0 percent and a survival time of 6.9 +/- 1.4 days, values that were 77.9 +/- 9.5 percent and 91.8 +/- 16.1 percent of the observation using "fresh" platelets, respectively. The area under the curve using Day 5 platelets was 67.8 +/- 11.5 percent of that using "fresh" platelets. CONCLUSION The proposed criterion for objective evaluation of platelet preparation and storage systems appears applicable to a commonly accepted approach, leukoreduced apheresis platelets stored in plasma for 5 days, and merits evaluation using other collection, treatment, and storage systems.
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Affiliation(s)
- James P AuBuchon
- Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
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