1
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Gavioli G, Razzoli A, Bedolla DE, Di Bartolomeo E, Quartieri E, Iotti B, Berni P, Birarda G, Vaccari L, Schiroli D, Marraccini C, Baricchi R, Merolle L. Cryopreservation affects platelet macromolecular composition over time after thawing and differently impacts on cancer cells behavior in vitro. Platelets 2023; 34:2281943. [PMID: 38010129 DOI: 10.1080/09537104.2023.2281943] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
Cryopreservation affects platelets' function, questioning their use for cancer patients. We aimed to investigate the biochemical events that occur over time after thawing to optimize transfusion timing and evaluate the effect of platelet supernatants on tumor cell behavior in vitro. We compared fresh (Fresh-PLT) with Cryopreserved platelets (Cryo-PLT) at 1 h, 3 h and 6 h after thawing. MCF-7 and HL-60 cells were cultured with Fresh- or 1 h Cryo-PLT supernatants to investigate cell proliferation, migration, and PLT-cell adhesion. We noticed a significant impairment of hemostatic activity accompanied by a post-thaw decrease of CD42b+ , which identifies the CD62P--population. FTIR spectroscopy revealed a decrease in the total protein content together with changes in their conformational structure, which identified two sub-groups: 1) Fresh and 1 h Cryo-PLT; 2) 3 h and 6 h cryo-PLT. Extracellular vesicle shedding and phosphatidylserine externalization (PS) increased after thawing. Cryo-PLT supernatants inhibited cell proliferation, impaired MCF-7 cell migration, and reduced ability to adhere to tumor cells. Within the first 3 hours after thawing, irreversible alterations of biomolecular structure occur in Cryo-PLT. Nevertheless, Cryo-PLT should be considered safe for the transfusion of cancer patients because of their insufficient capability to promote cancer cell proliferation, adhesion, or migration.
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Affiliation(s)
- Gaia Gavioli
- AUSL-IRCCS di Reggio Emilia, Transfusion Medicine Unit, Reggio Emilia, Italy
- Clinical and Experimental PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Agnese Razzoli
- AUSL-IRCCS di Reggio Emilia, Transfusion Medicine Unit, Reggio Emilia, Italy
- Clinical and Experimental PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Diana E Bedolla
- Elettra - Sincrotrone Trieste S.C.p.A, Basovizza, Italy
- Molecular Pathology Lab, International Center for Genetic Engineering and Biotechnology (ICGEB), Area Science Park, Trieste, Italy
- Center for Biospectroscopy and School of Chemistry, Monash University, Clayton, VIC, Australia
| | | | - Eleonora Quartieri
- AUSL-IRCCS di Reggio Emilia, Transfusion Medicine Unit, Reggio Emilia, Italy
| | - Barbara Iotti
- AUSL-IRCCS di Reggio Emilia, Transfusion Medicine Unit, Reggio Emilia, Italy
| | - Pamela Berni
- AUSL-IRCCS di Reggio Emilia, Transfusion Medicine Unit, Reggio Emilia, Italy
| | | | - Lisa Vaccari
- Elettra - Sincrotrone Trieste S.C.p.A, Basovizza, Italy
| | - Davide Schiroli
- AUSL-IRCCS di Reggio Emilia, Transfusion Medicine Unit, Reggio Emilia, Italy
| | - Chiara Marraccini
- AUSL-IRCCS di Reggio Emilia, Transfusion Medicine Unit, Reggio Emilia, Italy
| | - Roberto Baricchi
- AUSL-IRCCS di Reggio Emilia, Transfusion Medicine Unit, Reggio Emilia, Italy
| | - Lucia Merolle
- AUSL-IRCCS di Reggio Emilia, Transfusion Medicine Unit, Reggio Emilia, Italy
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2
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Raza S, Patriquin CJ, Yee K, Gupta A, Anani W, Wong J, Ellison C, Lieberman L, Pendergrast J, Cserti-Gazdewich C. Therapeutic plasma exchange in alloimmune platelet refractoriness. Transfus Apher Sci 2023; 62:103782. [PMID: 37550092 DOI: 10.1016/j.transci.2023.103782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023]
Abstract
Patients with alloimmune platelet refractoriness can present complex clinical conundrums. Herein we describe a case of platelet refractoriness in the setting of combined HLA and HPA alloimmunization in a patient with acute myeloid leukemia and life-threatening bleeding. We discuss causative antibodies and compare prevailing therapeutic modalities. We highlight plasma exchange as a potentially feasible, repeatable, and personalized treatment option for patients with extensive platelet alloimmunization who require transfusion.
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Affiliation(s)
| | | | - Karen Yee
- Division of Hematology, University of Toronto, Canada; Division of Malignant Hematology and Oncology, Princess Margaret Cancer Center, Canada
| | - Akash Gupta
- Division of Hematology, University of Toronto, Canada; National Platelet Immunobiology Laboratory, Canadian Blood Services, Canada
| | - Waseem Anani
- National Platelet Immunobiology Laboratory, Canadian Blood Services, Canada
| | - Jacqueline Wong
- National Platelet Immunobiology Laboratory, Canadian Blood Services, Canada
| | | | - Lani Lieberman
- Division of Hematology, University of Toronto, Canada; Blood Transfusion Laboratory, University Health Network, Canada
| | - Jacob Pendergrast
- Division of Hematology, University of Toronto, Canada; Blood Transfusion Laboratory, University Health Network, Canada
| | - Christine Cserti-Gazdewich
- Division of Hematology, University of Toronto, Canada; Blood Transfusion Laboratory, University Health Network, Canada.
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3
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Ang AL, Gan LSH, Tuy TT, Ang CH, Tan CW, Tan HH, Shu PH, Zhang Q, Cao Y, Moorakonda RB, Pokharkar Y, Lu J. A randomized cross-over study of cryopreserved platelets in prophylactic transfusions of thrombocytopenic patients. Transfusion 2023; 63:1649-1660. [PMID: 37596937 DOI: 10.1111/trf.17503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND The short shelf-life of liquid-stored platelets (LP) at 20-24°C poses shortage and wastage challenges. Cryopreserved platelets have significantly extended shelf-life, and were safe and efficacious for therapeutic transfusions of bleeding patients in the Afghanistan conflict and phase 2 randomized studies. Although hematology patients account for half of platelets demand, there is no randomized study on prophylactic cryopreserved platelet transfusions in them. METHODS We performed a phase 1b/2a randomized cross-over study comparing the safety and efficacy of cryopreserved buffy coat-derived pooled platelets (CP) to LP in the prophylactic transfusions of thrombocytopenic hematology patients. RESULTS A total of 18 adults were randomly assigned 1:1 to CP and LP for their first thrombocytopenic period (TP) of up to 28-days. A total of 14 crossed over to the other platelet-arm for the second TP. Overall, 17 subjects received 51 CP and 15 received 52 LP. CP-arm had more treatment emergent adverse event (29.4% vs. 13.3% of subjects, 9.8% vs. 3.8% of transfusions) than LP-arm but all were mild. No thromboembolism was observed. Both arms had similar bleeding rates (23.5% vs. 26.7% of subjects) which were all mild. Subjects in CP-arm had lower average corrected count increments than LP-arm (mean [SD] 5.6 [4.20] vs. 22.6 [9.68] ×109 /L at 1-4 h, p < .001; 5.3 [4.84] vs. 18.2 [9.52] ×109 /L at 18-30 h, p < .001). All TEG parameters at 1-4 h and maximum amplitude (MA) at 18-30 h improved from baseline post-CP transfusion (p < .05) though improvements in K-time and MA were lower than LP (p < .05). DISCUSSION During shortages, CP may supplement LP in prophylactic transfusions of thrombocytopenic patients.
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Affiliation(s)
- Ai Leen Ang
- Department of Hematology, Singapore General Hospital, Singapore
- Blood Services Group, Health Sciences Authority, Singapore
| | | | | | - Chieh Hwee Ang
- Department of Hematology, Singapore General Hospital, Singapore
| | - Chuen Wen Tan
- Department of Hematology, Singapore General Hospital, Singapore
| | - Hwee Huang Tan
- Blood Services Group, Health Sciences Authority, Singapore
| | - Pei Huey Shu
- Blood Services Group, Health Sciences Authority, Singapore
| | | | - Yang Cao
- Singapore Clinical Research Institute, Singapore
| | | | | | - Jia Lu
- DSO National Laboratories, Singapore
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4
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Johnson L, Lei P, Waters L, Padula MP, Marks DC. Identification of platelet subpopulations in cryopreserved platelet components using multi-colour imaging flow cytometry. Sci Rep 2023; 13:1221. [PMID: 36681723 PMCID: PMC9867743 DOI: 10.1038/s41598-023-28352-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
Cryopreservation of platelets, at - 80 °C with 5-6% DMSO, results in externalisation of phosphatidylserine and the formation of extracellular vesicles (EVs), which may mediate their procoagulant function. The phenotypic features of procoagulant platelets overlap with other platelet subpopulations. The aim of this study was to define the phenotype of in vitro generated platelet subpopulations, and subsequently identify the subpopulations present in cryopreserved components. Fresh platelet components (n = 6 in each group) were either unstimulated as a source of resting platelets; or stimulated with thrombin and collagen to generate a mixture of aggregatory and procoagulant platelets; calcium ionophore (A23187) to generate procoagulant platelets; or ABT-737 to generate apoptotic platelets. Platelet components (n = 6) were cryopreserved with DMSO, thawed and resuspended in a unit of thawed plasma. Multi-colour panels of fluorescent antibodies and dyes were used to identify the features of subpopulations by imaging flow cytometry. A combination of annexin-V (AnnV), CD42b, and either PAC1 or CD62P was able to distinguish the four subpopulations. Cryopreserved platelets contained procoagulant platelets (AnnV+/PAC1-/CD42b+/CD62P+) and a novel population (AnnV+/PAC1-/CD42b+/CD62P-) that did not align with the phenotype of aggregatory (AnnV-/PAC1+/CD42b+/CD62P+) or apoptotic (AnnV+/PAC1-/CD42b-/CD62P-) subpopulations. These data suggests that the enhanced haemostatic potential of cryopreserved platelets may be due to the cryo-induced development of procoagulant platelets, and that additional subpopulations may exist.
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Affiliation(s)
- Lacey Johnson
- Research and Development, Australian Red Cross Lifeblood, Alexandria, NSW, Australia.
- School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia.
| | - Pearl Lei
- Research and Development, Australian Red Cross Lifeblood, Alexandria, NSW, Australia
- School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - Lauren Waters
- Research and Development, Australian Red Cross Lifeblood, Alexandria, NSW, Australia
| | - Matthew P Padula
- School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Lifeblood, Alexandria, NSW, Australia
- Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
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Noorman F, Rijnhout TWH, de Kort B, Hoencamp R. Frozen for combat: Quality of deep-frozen thrombocytes, produced and used by The Netherlands Armed Forces 2001-2021. Transfusion 2023; 63:203-216. [PMID: 36318083 PMCID: PMC10092739 DOI: 10.1111/trf.17166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/19/2022] [Accepted: 10/08/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND The Netherlands Armed Forces (NLAF) are using -80°C deep-frozen thrombocyte concentrate (DTC) since 2001. The aim of this study is to investigate the effect of storage duration and alterations in production/measurement techniques on DTC quality. It is expected that DTC quality is unaffected by storage duration and in compliance with the European guidelines for fresh and cryopreserved platelets. STUDY DESIGN AND METHODS Pre-freeze and post-thaw product platelet content and recovery were collected to analyze the effects of dimethyl sulfoxide (DMSO) type, duration of frozen storage (DMSO-1 max 12 years and DMSO-2 frozen DTC max 4 years at -80°C) and type of plasma used to suspend DTC. Coagulation characteristics of thawed DTC, plasma and supernatant of DTC (2× 2500 G) were measured with Kaolin thromboelastography (TEG) and phospholipid (PPL) activity assay. RESULTS Platelet content and recovery of DTC is ±10%-15% lower in short-stored products and remained stable when stored beyond 0.5 years. Thawed DTC (n = 1724) were compliant to the European guidelines (98.1% post-thaw product recovery ≥50% from original product, 98.3% ≥200 × 109 platelets/unit). Compared to DMSO-1, products frozen with DMSO-2 showed ±8% reduced thaw-freeze recovery, a higher TEG clot strength (MA 58 [6] vs. 64 [8] mm) and same ±11 s PPL clotting time. The use of cold-stored thawed plasma instead of fresh thawed plasma did not influence product recovery or TEG-MA. DISCUSSION Regardless of alterations, product quality was in compliance with European guidelines and unaffected by storage duration up to 12 years of -80°C frozen storage.
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Affiliation(s)
- Femke Noorman
- Military Blood Bank, Ministry of Defense, Utrecht, The Netherlands
| | - Tim W H Rijnhout
- Department of Surgery, Alrijne Medical Centre, Leiderdorp, The Netherlands.,Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Bob de Kort
- Military Blood Bank, Ministry of Defense, Utrecht, The Netherlands
| | - Rigo Hoencamp
- Department of Surgery, Alrijne Medical Centre, Leiderdorp, The Netherlands.,Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Defense Healthcare Organization, Ministry of Defense, Utrecht, The Netherlands.,Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands
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6
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Hegde S, Zheng Y, Cancelas JA. Novel blood derived hemostatic agents for bleeding therapy and prophylaxis. Curr Opin Hematol 2022; 29:281-289. [PMID: 35942861 PMCID: PMC9547927 DOI: 10.1097/moh.0000000000000737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Hemorrhage is a major cause of preventable death in trauma and cancer. Trauma induced coagulopathy and cancer-associated endotheliopathy remain major therapeutic challenges. Early, aggressive administration of blood-derived products with hypothesized increased clotting potency has been proposed. A series of early- and late-phase clinical trials testing the safety and/or efficacy of lyophilized plasma and new forms of platelet products in humans have provided light on the future of alternative blood component therapies. This review intends to contextualize and provide a critical review of the information provided by these trials. RECENT FINDINGS The beneficial effect of existing freeze-dried plasma products may not be as high as initially anticipated when tested in randomized, multicenter clinical trials. A next-generation freeze dried plasma product has shown safety in an early phase clinical trial and other freeze-dried plasma and spray-dried plasma with promising preclinical profiles are embarking in first-in-human trials. New platelet additive solutions and forms of cryopreservation or lyophilization of platelets with long-term shelf-life have demonstrated feasibility and logistical advantages. SUMMARY Recent trials have confirmed logistical advantages of modified plasma and platelet products in the treatment or prophylaxis of bleeding. However, their postulated increased potency profile remains unconfirmed.
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Affiliation(s)
- Shailaja Hegde
- Hoxworth Blood Center, University of Cincinnati Academic Health Center
| | - Yi Zheng
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jose A Cancelas
- Hoxworth Blood Center, University of Cincinnati Academic Health Center
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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7
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Jimenez-Marco T, Castrillo A, Hierro-Riu F, Vicente V, Rivera J. Frozen and cold-stored platelets: reconsidered platelet products. Platelets 2021; 33:27-34. [PMID: 34423718 DOI: 10.1080/09537104.2021.1967917] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Platelet transfusion, both prophylactic and therapeutic, is a key element in modern medicine. Currently, the standard platelet product for clinical use is platelet concentrates at room temperature (20-24°C) under gentle agitation. As this temperature favors bacterial growth, storage is limited to 5-7 days, which result in high wastage rate, and complicates inventory and product availability at remote areas. Frozen and/or cold storage would ameliorate those disadvantages by reducing the risk of bacterial contamination and by extending the product shelf-life to weeks or even years. Consequently, the usefulness in transfusion medicine of platelet cryopreservation and refrigeration, two old and scarcely used platelet storage approaches, is reemerging. Indeed, there have been substantial recent research efforts to characterize both cold and cryopreserved platelets. Most recent studies indicate that cryopreserved and cold platelets display a pro-coagulant profile that may produce the rapid hemostatic response which is needed in bleeding patients. Thus, it seems appropriate that blood banks and blood transfusion centers explore the possibility of split platelet inventories consisting of platelets stored at room temperature and cryopreserved and cold-stored platelets.
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Affiliation(s)
- Teresa Jimenez-Marco
- Fundació Banc De Sang I Teixits De Les Illes Balears, Majorca, Spain.,Institut d'Investigació Sanitària Illes Balears (Idisba), Majorca, Spain
| | - Azucena Castrillo
- Axencia Galega De Sangue, Órganos E Tecidos. Santiago De Compostela, A Coruña, Spain
| | | | - Vicente Vicente
- Servicio De Hematología Y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional De Hemodonación, Universidad De Murcia, IMIB-Arrixaca, Murcia, Spain
| | - José Rivera
- Servicio De Hematología Y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional De Hemodonación, Universidad De Murcia, IMIB-Arrixaca, Murcia, Spain
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8
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Platelet Transfusion-Insights from Current Practice to Future Development. J Clin Med 2021; 10:jcm10091990. [PMID: 34066360 PMCID: PMC8125287 DOI: 10.3390/jcm10091990] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 12/12/2022] Open
Abstract
Since the late sixties, therapeutic or prophylactic platelet transfusion has been used to relieve hemorrhagic complications of patients with, e.g., thrombocytopenia, platelet dysfunction, and injuries, and is an essential part of the supportive care in high dose chemotherapy. Current and upcoming advances will significantly affect present standards. We focus on specific issues, including the comparison of buffy-coat (BPC) and apheresis platelet concentrates (APC); plasma additive solutions (PAS); further measures for improvement of platelet storage quality; pathogen inactivation; and cold storage of platelets. The objective of this article is to give insights from current practice to future development on platelet transfusion, focusing on these selected issues, which have a potentially major impact on forthcoming guidelines.
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9
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Jimenez-Marco T, Ballester-Servera C, Quetglas-Oliver M, Morell-Garcia D, Torres-Reverte N, Bautista-Gili AM, Serra-Ramon N, Girona-Llobera E. Cryopreservation of platelets treated with riboflavin and UV light and stored at -80°C for 1 year. Transfusion 2021; 61:1235-1246. [PMID: 33694171 DOI: 10.1111/trf.16324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 01/04/2021] [Accepted: 01/10/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The combination of pathogen reduction technologies (PRTs) and cryopreservation can contribute to building a safe and durable platelet (PLT) inventory. Information about cryopreserved riboflavin and UV light-treated PLTs is scarce. STUDY DESIGN AND METHODS Twenty-four buffy coat (BC) PLT concentrates were grouped into 12 type-matched pairs, pooled, and divided into 12 non-PRT-treated control units and 12 riboflavin and UV light PRT-treated test units. Both were cryopreserved with 5% DMSO and stored at -80°C for 1 year. The cryopreservation method used was designed to avoid the formation of aggregates. PLT variables (PLT recovery, swirling, pH, MPV, and LDH) and hemostatic function measured by thromboelastography (TEG) were analyzed before cryopreservation (day 1) and post-cryopreservation at day 14 and months 3, 6, and 12 of storage at -80°C. The analyses were carried out within 1-h post-thaw. RESULTS No aggregates were found in either PLT group at any time. Swirling was observed in both groups. MPV increased and mean pH values decreased over time (p < .001), but the mean pH value was never below 6.4 in either group after 12 months of storage at -80°C. PLT recovery was good and clotting time became significantly shorter over the storage period in both groups (p < .001). CONCLUSION Our cryopreservation and thawing method prevented aggregate formation in cryopreserved riboflavin-UV-light-treated PLTs, which exhibited good recovery, swirling, pH > 6.4, and procoagulant potential, as evidenced by a reduced clotting time after 12 months of storage at -80°C. The clinical relevance of these findings should be further investigated in clinical trials.
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Affiliation(s)
- Teresa Jimenez-Marco
- Fundació Banc de Sang i Teixits de les Illes Balears, Majorca, Spain.,Institut d'Investigació Sanitària Illes Balears (IdISBa), Majorca, Spain
| | | | | | - Daniel Morell-Garcia
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Majorca, Spain.,Servicio de Análisis Clínicos, Hospital Universitari Son Espases, Majorca, Spain
| | | | - Antonia M Bautista-Gili
- Fundació Banc de Sang i Teixits de les Illes Balears, Majorca, Spain.,Institut d'Investigació Sanitària Illes Balears (IdISBa), Majorca, Spain
| | - Neus Serra-Ramon
- Fundació Banc de Sang i Teixits de les Illes Balears, Majorca, Spain
| | - Enrique Girona-Llobera
- Fundació Banc de Sang i Teixits de les Illes Balears, Majorca, Spain.,Institut d'Investigació Sanitària Illes Balears (IdISBa), Majorca, Spain
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10
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Aliotta A, Bertaggia Calderara D, Zermatten MG, Marchetti M, Alberio L. Thrombocytopathies: Not Just Aggregation Defects-The Clinical Relevance of Procoagulant Platelets. J Clin Med 2021; 10:jcm10050894. [PMID: 33668091 PMCID: PMC7956450 DOI: 10.3390/jcm10050894] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/31/2021] [Accepted: 02/12/2021] [Indexed: 01/08/2023] Open
Abstract
Platelets are active key players in haemostasis. Qualitative platelet dysfunctions result in thrombocytopathies variously characterized by defects of their adhesive and procoagulant activation endpoints. In this review, we summarize the traditional platelet defects in adhesion, secretion, and aggregation. In addition, we review the current knowledge about procoagulant platelets, focusing on their role in bleeding or thrombotic pathologies and their pharmaceutical modulation. Procoagulant activity is an important feature of platelet activation, which should be specifically evaluated during the investigation of a suspected thrombocytopathy.
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Affiliation(s)
- Alessandro Aliotta
- Hemostasis and Platelet Research Laboratory, Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), CH-1010 Lausanne, Switzerland; (A.A.); (D.B.C.); (M.G.Z.); (M.M.)
| | - Debora Bertaggia Calderara
- Hemostasis and Platelet Research Laboratory, Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), CH-1010 Lausanne, Switzerland; (A.A.); (D.B.C.); (M.G.Z.); (M.M.)
| | - Maxime G. Zermatten
- Hemostasis and Platelet Research Laboratory, Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), CH-1010 Lausanne, Switzerland; (A.A.); (D.B.C.); (M.G.Z.); (M.M.)
| | - Matteo Marchetti
- Hemostasis and Platelet Research Laboratory, Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), CH-1010 Lausanne, Switzerland; (A.A.); (D.B.C.); (M.G.Z.); (M.M.)
- Service de Médecine Interne, Hôpital de Nyon, CH-1260 Nyon, Switzerland
| | - Lorenzo Alberio
- Hemostasis and Platelet Research Laboratory, Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), CH-1010 Lausanne, Switzerland; (A.A.); (D.B.C.); (M.G.Z.); (M.M.)
- Correspondence:
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11
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Saris A, Pavenski K. Human Leukocyte Antigen Alloimmunization and Alloimmune Platelet Refractoriness. Transfus Med Rev 2020; 34:250-257. [PMID: 33127210 DOI: 10.1016/j.tmrv.2020.09.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/13/2020] [Accepted: 09/16/2020] [Indexed: 02/06/2023]
Abstract
Despite significant advancements in the production of platelet products, storage, and transfusion, transfusion refractoriness remains a significant clinical problem, affecting up to 14% of hematological patients receiving platelet transfusions. Human leukocyte antigen (HLA) alloimmunization is a major cause of immune platelet refractoriness, and its rate can be significantly reduced by implementation of leukoreduction. Despite promising preclinical results, pathogen reduction does not reduce HLA alloimmunization. Patients with HLA alloimmune refractoriness are usually managed with HLA-selected platelet transfusions. In this review, we describe the pathophysiology of HLA alloimmunization and alloimmune refractoriness, as well as options to prevent and treat these transfusion complications. We discuss the evidence supporting these options and point out the outstanding gaps. Finally, we review the possible future directions for prevention and treatment of alloimmune refractoriness.
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Affiliation(s)
- Anno Saris
- Department of Infectious Diseases, Leiden University Medical Centre, Leiden, the Netherlands.
| | - Katerina Pavenski
- Departments of Medicine and Laboratory Medicine, St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada.
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12
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Frozen Platelets-Development and Future Directions. Transfus Med Rev 2020; 34:286-293. [PMID: 33317698 DOI: 10.1016/j.tmrv.2020.09.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 02/01/2023]
Abstract
Storage requirements and outdating of platelets represent a continued challenge for blood banks. These hurdles are confounded for rural area hospitals or in military deployments. Over 60 years of research and development into frozen platelets have generated a stable and reproducible product. Valeri's method to freeze platelets in 6% dimethyl sulfoxide (DMSO) and storage at -80°C allows for long-term storage alleviating burdens placed on blood banks. Clinical studies show that frozen platelet transfusions are safe with no related thrombotic or other serious adverse events. There are ongoing efforts to demonstrate cryopreserved platelet (CPP) superiority in efficacy studies designed in trauma or cardiac surgery patients. Technical advances in CPP manufacturing including closed system manufacturing, applications of pathogen reduction technology and potency standard characterization add to the appeal of CPP as an alternative to traditional liquid-stored platelets (LP) in settings of supply shortages, mass casualty, active bleeding, rapid provision of HLA-compatible platelets, and remote care.
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13
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Abstract
AbstractThe characterization of platelet concentrates (PCs) in transfusion medicine has been performed with different analytical methods and platelet lesions (from biochemistry to cell biology) have been documented. In routine quality assessment and validation of manufacturing processes of PCs for transfusion purposes, only basic parameters are monitored and the platelet functions are not included. However, PCs undergo several manipulations during the processing and the basic parameters do not provide sensitive analyses to properly picture out the impact of the blood component preparation and storage on platelets. To improve the transfusion supply chain and the platelet functionalities, additional parameters should be used. The present short review will focus on the different techniques to monitor ex vivo platelet lesions from phenotype characterization to advanced omic analyses. Then, the opportunities to use these methods in quality control, process validation, development, and research will be discussed. Functional markers should be considered because they would be an advantage for the future developments in transfusion medicine.
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Platelet Biochemistry and Morphology after Cryopreservation. Int J Mol Sci 2020; 21:ijms21030935. [PMID: 32023815 PMCID: PMC7036941 DOI: 10.3390/ijms21030935] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/24/2020] [Accepted: 01/29/2020] [Indexed: 12/25/2022] Open
Abstract
Platelet cryopreservation has been investigated for several decades as an alternative to room temperature storage of platelet concentrates. The use of dimethylsulfoxide as a cryoprotectant has improved platelet storage and cryopreserved concentrates can be kept at −80 °C for two years. Cryopreserved platelets can serve as emergency backup to support stock crises or to disburden difficult logistic areas like rural or military regions. Cryopreservation significantly influences platelet morphology, decreases platelet activation and severely abrogates platelet aggregation. Recent data indicate that cryopreserved platelets have a procoagulant phenotype because thrombin and fibrin formation kicks in earlier compared to room temperature stored platelets. This happens both in static and hydrodynamic conditions. In a clinical setting, low 1-h post transfusion recoveries of cryopreserved platelets represent fast clearance from circulation which may be explained by changes to the platelet GPIbα receptor. Cryopreservation splits the concentrate in two platelet subpopulations depending on GPIbα expression levels. Further research is needed to unravel its physiological importance. Proving clinical efficacy of cryopreserved platelets is difficult because of the heterogeneity of indications and the ambiguity of outcome measures. The procoagulant character of cryopreserved platelets has increased interest for use in trauma stressing the need for double-blinded randomized clinical trials in actively bleeding patients.
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15
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Johnson L, Waters L, Green S, Wood B, Marks DC. Freezing expired platelets does not compromise in vitro quality: An opportunity to maximize inventory potential. Transfusion 2019; 60:454-459. [PMID: 31782799 DOI: 10.1111/trf.15616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/30/2019] [Accepted: 11/12/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Cryopreservation provides an option for long-term storage of platelet concentrates. While platelets are usually frozen as soon as practical after collection (within 2 days), the ability to freeze units at a later stage of the shelf life may improve inventory management. As such, the aim of this study was to determine the impact of freezing platelets approaching expiry (Day 5/6). MATERIALS AND METHODS Two ABO-matched buffy coat-derived platelets (30% plasma/70% platelet additive solution) were pooled and split to produce matched pairs (n = 8 pairs). Platelets were frozen on Day 1 after collection (cryopreserved platelets [CPPs]) or Day 5 or 6 (expired-CPPs) at -80°C with 5% to 6% dimethyl sulfoxide. In vitro platelet quality was tested before freezing and after thawing and reconstitution in plasma. RESULTS The majority of prefreeze parameters were equivalent for all platelet units (Day 1 vs. Day 5 or 6). Expired-CPPs had a higher mean postthaw platelet recovery (82 ± 4%) compared to CPPs (75 ± 4%; p = 0.0021). Cryopreservation resulted in a loss of surface glycoproteins (glycoprotein (GP) Ibα, GPIIb, GPVI), an increase in activation markers (phosphatidylserine and P-selectin) and microparticle release, compared to unfrozen platelets. However, the cryopreservation-induced changes were equivalent in CPPs and expired-CPPs. Functionality was measured by thromboelastography and was similar between expired-CPPs (R-time: 5.3 ± 0.3) and CPPs (R-time: 5.4 ± 0.5; p = 0.7094). CONCLUSION The phenotype and functional profile of platelets frozen at expiry were similar to platelets frozen 1 day following collection. These data suggest that expired platelets may represent a suitable starting material for cryopreservation.
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Affiliation(s)
- Lacey Johnson
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
| | - Lauren Waters
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
| | - Sarah Green
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
| | - Ben Wood
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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16
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Cohn CS, Williams S. Cryopreserved platelets: the thaw begins …
(Article, p. 2794). Transfusion 2019; 59:2759-2762. [DOI: 10.1111/trf.15465] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 07/15/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Claudia S. Cohn
- Department of Laboratory Medicine and PathologyUniversity of Minnesota Minneapolis MN
| | - Shelly Williams
- Department of Laboratory Medicine and PathologyUniversity of Minnesota Minneapolis MN
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17
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Bertaggia Calderara D, Crettaz D, Aliotta A, Barelli S, Tissot JD, Prudent M, Alberio L. Generation of procoagulant collagen- and thrombin-activated platelets in platelet concentrates derived from buffy coat: the role of processing, pathogen inactivation, and storage. Transfusion 2018; 58:2395-2406. [PMID: 30229925 DOI: 10.1111/trf.14883] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/09/2018] [Accepted: 07/09/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Collagen- and thrombin-activated (COAT) platelets (PLTs), generated by dual-agonist stimulation with collagen and thrombin (THR), enhance THR generation at the site of vessel wall injury. There is evidence that higher amounts of procoagulant COAT PLTs are associated with stroke, while a decreased ability to generate them is associated with bleeding diathesis. Our aim was to study PLT functions, particularly the ability to generate COAT PLTs, in PLT concentrates (PCs) from buffy coat. Thus, we investigated the effect of processing, pathogen inactivation treatment (amotosalen-UVA), and PC storage. STUDY DESIGN AND METHODS Two PCs from five donors each were pooled and split in two bags; one of them was pathogen inactivated and the other one was left untreated (n = 5). Flow cytometric analyses were performed immediately after PC preparation (Day 1) and thereafter on Days 2, 5, 7, and 9 in treated and untreated PCs to measure the reactivity of PLTs (CD62P and PAC-1), the content and secretion of dense granule after stimulation with different agonists, and the percentage of COAT PLTs after dual stimulation with convulxin (agonist of the collagen receptor GPVI) and THR. RESULTS Preparation of PCs resulted in a significant decrease of COAT PLTs and in an impaired response to adenosine 5'-diphosphate sodium (ADP). Storage further decreased ADP response. Minor differences were observed between untreated or amotosalen-UVA-treated PCs. CONCLUSION Preparation of PCs from buffy coats decreased the ability to generate COAT PLTs and impaired PLT response to ADP.
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Affiliation(s)
- Debora Bertaggia Calderara
- Division of Hematology and Central Hematology Laboratory, CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - David Crettaz
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - Alessandro Aliotta
- Division of Hematology and Central Hematology Laboratory, CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
| | - Stefano Barelli
- Division of Hematology and Central Hematology Laboratory, CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean-Daniel Tissot
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
| | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, Epalinges, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
| | - Lorenzo Alberio
- Division of Hematology and Central Hematology Laboratory, CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
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18
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Marks DC. Cryopreserved platelets: are we there yet? Transfusion 2018; 58:2092-2094. [DOI: 10.1111/trf.14887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 07/10/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Denese C. Marks
- Research and Development; The Australian Red Cross Blood Service
- Sydney Medical School; The University of Sydney; Sydney Australia
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19
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Marks DC, Johnson L, Reade MC. A clinical trial of frozen platelets: rationale, protocol and pilot analysis plan. ACTA ACUST UNITED AC 2018. [DOI: 10.1111/voxs.12406] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- D. C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
- Sydney Medical School; University of Sydney; Sydney NSW Australia
| | - L. Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - M. C. Reade
- Faculty of Medicine; University of Queensland; Brisbane QLD Australia
- Joint Health Command; Australian Defence Force; Canberra ACT Australia
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20
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Cohn C, Dumont L, Lozano M, Marks D, Johnson L, Ismay S, Bondar N, T'Sas F, Yokoyama A, Kutner J, Acker J, Bohonek M, Sailliol A, Martinaud C, Pogłód R, Antoniewicz-Papis J, Lachert E, Pun P, Lu J, Cid J, Guijarro F, Puig L, Gerber B, Alberio L, Schanz U, Buser A, Noorman F, Zoodsma M, van der Meer P, de Korte D, Wagner S, O'Neill M. Vox Sanguinis International Forum on platelet cryopreservation. Vox Sang 2017; 112:e69-e85. [DOI: 10.1111/vox.12532] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
| | | | | | - D.C. Marks
- Australian Red Cross Blood Service; 17 O'Riordan Street Alexandria NSW 2015 Australia
| | - L. Johnson
- Australian Red Cross Blood Service; 17 O'Riordan Street Alexandria NSW 2015 Australia
| | - S. Ismay
- Australian Red Cross Blood Service; 17 O'Riordan Street Alexandria NSW 2015 Australia
| | - N. Bondar
- Australian Red Cross Blood Service; 17 O'Riordan Street Alexandria NSW 2015 Australia
| | - F. T'Sas
- HMRA - Service Militaire de Transfusion Sanguine; Rue Bruyn 1 1120 Bruxelles Belgique
| | - A.P.H. Yokoyama
- Departamento de Hemoterapia; Hospital Israelita Albert Einstein; Av. Albert Einstein, 627 Sao Paulo SP 05651-901 Brazil
| | - J.M. Kutner
- Departamento de Hemoterapia; Hospital Israelita Albert Einstein; Av. Albert Einstein, 627 Sao Paulo SP 05651-901 Brazil
| | - J.P. Acker
- Canadian Blood Services; 8249-114 Street Edmonton AB T6G 2R8 Canada
| | - M. Bohonek
- Department of Hematology and Blood Transfusion; Military University Hospital Prague; U Vojenske nemocnice 1200 Prague 169 02 Czech Republic
| | - A. Sailliol
- French Military Blood Institute; 1 rue de Lieutenant Batany Clamart 92140 France
| | - C. Martinaud
- French Military Blood Institute; 1 rue de Lieutenant Batany Clamart 92140 France
| | - R. Pogłód
- Zakład Transfuzjologii; Instytut Hematologii i Transfuzjologii; ul. I. Gandhi 14 Warszawa 02-776 Poland
| | - J. Antoniewicz-Papis
- Institute of Hematology and Transfusion Medicine; Indiry Gandhi 14 Warsaw 02-776 Poland
| | - E. Lachert
- Institute of Hematology and Transfusion Medicine; Indiry Gandhi 14 Warsaw 02-776 Poland
| | - P.B.L. Pun
- Defence Medical & Environmental Research Institute; DSO National Laboratories (Kent Ridge); 27 Medical Drive Singapore 117510
| | - J. Lu
- Defence Medical & Environmental Research Institute; DSO National Laboratories (Kent Ridge); 27 Medical Drive Singapore 117510
| | - J. Cid
- Apheresis Unit; Department of Hemotherapy and Hemostasis; ICMHO; Hospital Clínic; Villarroel 170 Barcelona Catalonia 08036 Spain
| | - F. Guijarro
- Apheresis Unit; Department of Hemotherapy and Hemostasis; ICMHO; IDIBAPS; Hospital Clínic; University of Barcelona; Barcelona Spain
| | - L. Puig
- Banc de Sang i Teixits de Catalunya; Transfusion Safety Laboratory; Barcelona Spain
| | - B. Gerber
- Division of Hematology; Oncology Institute of Southern Switzerland; Bellinzona CH-6500 Switzerland
| | - L. Alberio
- Division of Hematology and Central Hematology Laboratory; CHUV; Lausanne University Hospital; Lausanne Switzerland
| | - U. Schanz
- Division of Hematology; University and University Hospital Zurich; Zurich Switzerland
| | - A. Buser
- Hematology; University Hospital Basel; Basel Switzerland
| | - F. Noorman
- Military Blood Bank; Plesmanlaan 1c 2333 BZ The Netherlands
| | - M. Zoodsma
- Military Blood Bank; Plesmanlaan 1c 2333 BZ The Netherlands
| | - P.F. van der Meer
- Department of Product and Process Development; Sanquin Blood Bank; Plesmanlaan 125 Amsterdam 1066 CX The Netherlands
| | - D. de Korte
- Sanquin Blood Bank North West Region; Plesmanlaan 125 Amsterdam 1066 CX The Netherlands
| | - S. Wagner
- Transfusion Innovation Dept.; American Red Cross Holland Lab; 15601 Crabbs Branch Way Rockville MD 20855 USA
| | - M. O'Neill
- American Red Cross Medical Office; 180 Rustcraft Rd Dedham MA 020206 USA
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21
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Implications of the US Food and Drug Administration draft guidance for mitigating septic reactions from platelet transfusions. Blood Adv 2017; 1:1142-1147. [PMID: 29296756 DOI: 10.1182/bloodadvances.2017008334] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 06/02/2017] [Indexed: 01/19/2023] Open
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22
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Redox Proteomics and Platelet Activation: Understanding the Redox Proteome to Improve Platelet Quality for Transfusion. Int J Mol Sci 2017; 18:ijms18020387. [PMID: 28208668 PMCID: PMC5343922 DOI: 10.3390/ijms18020387] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/27/2017] [Accepted: 02/07/2017] [Indexed: 12/13/2022] Open
Abstract
Blood banks use pathogen inactivation (PI) technologies to increase the safety of platelet concentrates (PCs). The characteristics of PI-treated PCs slightly differ from those of untreated PCs, but the underlying reasons are not well understood. One possible cause is the generation of oxidative stress during the PI process. This is of great interest since reactive oxygen species (ROS) act as second messengers in platelet functions. Furthermore, there are links between protein oxidation and phosphorylation, another mechanism that is critical for cell regulation. Current research efforts focus on understanding the underlying mechanisms and identifying new target proteins. Proteomics technologies represent powerful tools for investigating signaling pathways involving ROS and post-translational modifications such as phosphorylation, while quantitative techniques enable the comparison of the platelet resting state versus the stimulated state. In particular, redox cysteine is a key player in platelet activation upon stimulation by different agonists. This review highlights the experiments that have provided insights into the roles of ROS in platelet function and the implications for platelet transfusion, and potentially in diseases such as inflammation and platelet hyperactivity. The review also describes the implication of redox mechanism in platelet storage considerations.
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Acker JP, Marks DC, Sheffield WP. Quality Assessment of Established and Emerging Blood Components for Transfusion. JOURNAL OF BLOOD TRANSFUSION 2016; 2016:4860284. [PMID: 28070448 PMCID: PMC5192317 DOI: 10.1155/2016/4860284] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/02/2016] [Indexed: 12/16/2022]
Abstract
Blood is donated either as whole blood, with subsequent component processing, or through the use of apheresis devices that extract one or more components and return the rest of the donation to the donor. Blood component therapy supplanted whole blood transfusion in industrialized countries in the middle of the twentieth century and remains the standard of care for the majority of patients receiving a transfusion. Traditionally, blood has been processed into three main blood products: red blood cell concentrates; platelet concentrates; and transfusable plasma. Ensuring that these products are of high quality and that they deliver their intended benefits to patients throughout their shelf-life is a complex task. Further complexity has been added with the development of products stored under nonstandard conditions or subjected to additional manufacturing steps (e.g., cryopreserved platelets, irradiated red cells, and lyophilized plasma). Here we review established and emerging methodologies for assessing blood product quality and address controversies and uncertainties in this thriving and active field of investigation.
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Affiliation(s)
- Jason P. Acker
- Centre for Innovation, Canadian Blood Services, Edmonton, AB, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Denese C. Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - William P. Sheffield
- Centre for Innovation, Canadian Blood Services, Hamilton, ON, Canada
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
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24
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Cid J. Autologous cryopreserved platelets to overcome immune platelet refractoriness. Transfusion 2016; 56:2403-2404. [PMID: 27739150 DOI: 10.1111/trf.13758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 07/06/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Joan Cid
- Apheresis Unit, Department of Hemotherapy and Hemostasis, IDIBAPS, Hospital Clínic, Barcelona, Spain.
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