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Burnouf T, Chou ML, Lundy DJ, Chuang EY, Tseng CL, Goubran H. Expanding applications of allogeneic platelets, platelet lysates, and platelet extracellular vesicles in cell therapy, regenerative medicine, and targeted drug delivery. J Biomed Sci 2023; 30:79. [PMID: 37704991 PMCID: PMC10500824 DOI: 10.1186/s12929-023-00972-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/23/2023] [Indexed: 09/15/2023] Open
Abstract
Platelets are small anucleated blood cells primarily known for their vital hemostatic role. Allogeneic platelet concentrates (PCs) collected from healthy donors are an essential cellular product transfused by hospitals to control or prevent bleeding in patients affected by thrombocytopenia or platelet dysfunctions. Platelets fulfill additional essential functions in innate and adaptive immunity and inflammation, as well as in wound-healing and tissue-repair mechanisms. Platelets contain mitochondria, lysosomes, dense granules, and alpha-granules, which collectively are a remarkable reservoir of multiple trophic factors, enzymes, and signaling molecules. In addition, platelets are prone to release in the blood circulation a unique set of extracellular vesicles (p-EVs), which carry a rich biomolecular cargo influential in cell-cell communications. The exceptional functional roles played by platelets and p-EVs explain the recent interest in exploring the use of allogeneic PCs as source material to develop new biotherapies that could address needs in cell therapy, regenerative medicine, and targeted drug delivery. Pooled human platelet lysates (HPLs) can be produced from allogeneic PCs that have reached their expiration date and are no longer suitable for transfusion but remain valuable source materials for other applications. These HPLs can substitute for fetal bovine serum as a clinical grade xeno-free supplement of growth media used in the in vitro expansion of human cells for transplantation purposes. The use of expired allogeneic platelet concentrates has opened the way for small-pool or large-pool allogeneic HPLs and HPL-derived p-EVs as biotherapy for ocular surface disorders, wound care and, potentially, neurodegenerative diseases, osteoarthritis, and others. Additionally, allogeneic platelets are now seen as a readily available source of cells and EVs that can be exploited for targeted drug delivery vehicles. This article aims to offer an in-depth update on emerging translational applications of allogeneic platelet biotherapies while also highlighting their advantages and limitations as a clinical modality in regenerative medicine and cell therapies.
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Affiliation(s)
- Thierry Burnouf
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, 250 Wu-Xing Street, Taipei, 11031, Taiwan.
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan.
- International Ph.D. Program in Cell Therapy and Regenerative Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Ming-Li Chou
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, 250 Wu-Xing Street, Taipei, 11031, Taiwan
- Institute of Clinical Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - David J Lundy
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, 250 Wu-Xing Street, Taipei, 11031, Taiwan
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Er-Yuan Chuang
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, 250 Wu-Xing Street, Taipei, 11031, Taiwan
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Ching-Li Tseng
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, 250 Wu-Xing Street, Taipei, 11031, Taiwan
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Hadi Goubran
- Saskatoon Cancer Centre and College of Medicine, University of Saskatchewan, Saskatchewan, Canada
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Mowla SJ, Kracalik IT, Sapiano MRP, O'Hearn L, Andrzejewski C, Basavaraju SV. A Comparison of Transfusion-Related Adverse Reactions Among Apheresis Platelets, Whole Blood-Derived Platelets, and Platelets Subjected to Pathogen Reduction Technology as Reported to the National Healthcare Safety Network Hemovigilance Module. Transfus Med Rev 2021; 35:78-84. [PMID: 33934903 DOI: 10.1016/j.tmrv.2021.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/04/2021] [Accepted: 03/23/2021] [Indexed: 01/23/2023]
Abstract
Despite advances in transfusion safety, concerns with safety of platelet transfusions remain including platelet-related sepsis and higher reaction rates observed among patients receiving apheresis platelets (APLTs). National Healthcare Safety Network (NHSN) Hemovigilance Module (HM) data were analyzed to quantify the burden and severity of adverse reactions occurring from APLTs and whole blood-derived platelets (WBD-PLTs). Facilities participating in NHSN HM during 2010-2018 were included. Adverse reaction rates (number per 100,000 components transfused) were calculated for APLTs and WBD-PLTs stratified by severity, use of platelet additive solution (PAS), and pathogen reduction technology (PRT). Chi-square tests were used to compare rates. During the study interval, 2,000,589 platelets were transfused: 1,435,154 APLTs; 525,902 WBD-PLTs; and among APLTs, 39,533 PRT-APLTs. APLT adverse reaction rates were higher (478 vs 70/ 100,000, P< .01) and more often serious (34 vs 6/100,000; P< .01) compared with WBD-PLTs. Adverse reactions were higher among PRT-APLTs (572/100,000) and were less often serious (18/100,000) compared with non-PRT-APLTs (35/100,000) although this association was not statistically significant. Among components implicated in adverse reactions, 92% of APLTs were suspended in plasma. Compared with PRT-APLTs stored in PAS, rates were higher among units stored in plasma (760 vs 525/100,000). Most serious reactions (75%) were allergic. No transfusion-transmitted infections were reported among PRT-APLTs. APLTs were associated with a 6-fold and 2-fold higher serious adverse reaction risks compared with WBD-PLTs and PRT-APLTs, respectively. These findings demonstrate the importance of monitoring transfusion-related adverse reactions to track the safety of platelet transfusions and quantify the impact of mitigation strategies through national hemovigilance systems.
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Affiliation(s)
- Sanjida J Mowla
- Oak Ridge Institute for Science and Education (ORISE), Centers for Disease Control and Prevention, Atlanta, GA, USA; Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Ian T Kracalik
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mathew R P Sapiano
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lynne O'Hearn
- Department of Pathology, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Chester Andrzejewski
- Department of Pathology, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Sridhar V Basavaraju
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Assessment of soluble platelet CD40L and CD62P during the preparation process and the storage of apheresis platelet concentrates: Absence of factors related to donors and donations. Transfus Clin Biol 2018; 25:192-196. [DOI: 10.1016/j.tracli.2018.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 07/02/2018] [Indexed: 01/10/2023]
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Improving platelet transfusion safety: biomedical and technical considerations. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 14:109-22. [PMID: 26674828 DOI: 10.2450/2015.0042-15] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 07/16/2015] [Indexed: 12/25/2022]
Abstract
Platelet concentrates account for near 10% of all labile blood components but are responsible for more than 25% of the reported adverse events. Besides factors related to patients themselves, who may be particularly at risk of side effects because of their underlying illness, there are aspects of platelet collection and storage that predispose to adverse events. Platelets for transfusion are strongly activated by collection through disposal equipment, which can stress the cells, and by preservation at 22 °C with rotation or rocking, which likewise leads to platelet activation, perhaps more so than storage at 4 °C. Lastly, platelets constitutively possess a very large number of bioactive components that may elicit pro-inflammatory reactions when infused into a patient. This review aims to describe approaches that may be crucial to minimising side effects while optimising safety and quality. We suggest that platelet transfusion is complex, in part because of the complexity of the "material" itself: platelets are highly versatile cells and the transfusion process adds a myriad of variables that present many challenges for preserving basal platelet function and preventing dysfunctional activation of the platelets. The review also presents information showing--after years of exhaustive haemovigilance--that whole blood buffy coat pooled platelet components are extremely safe compared to the gold standard (i.e. apheresis platelet components), both in terms of acquired infections and of immunological/inflammatory hazards.
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Knutson F, Osselaer J, Pierelli L, Lozano M, Cid J, Tardivel R, Garraud O, Hervig T, Domanovic D, Cukjati M, Gudmundson S, Hjalmarsdottir IB, Castrillo A, Gonzalez R, Brihante D, Santos M, Schlenke P, Elliott A, Lin JS, Tappe D, Stassinopoulos A, Green J, Corash L. A prospective, active haemovigilance study with combined cohort analysis of 19,175 transfusions of platelet components prepared with amotosalen-UVA photochemical treatment. Vox Sang 2015; 109:343-52. [PMID: 25981525 PMCID: PMC4690512 DOI: 10.1111/vox.12287] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 03/24/2015] [Accepted: 03/27/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES A photochemical treatment process (PCT) utilizing amotosalen and UVA light (INTERCEPT(™) Blood System) has been developed for inactivation of viruses, bacteria, parasites and leucocytes that can contaminate blood components intended for transfusion. The objective of this study was to further characterize the safety profile of INTERCEPT-treated platelet components (PCT-PLT) administered across a broad patient population. MATERIALS AND METHODS This open-label, observational haemovigilance programme of PCT-PLT transfusions was conducted in 21 centres in 11 countries. All transfusions were monitored for adverse events within 24 h post-transfusion and for serious adverse events (SAEs) up to 7 days post-transfusion. All adverse events were assessed for severity (Grade 0-4), and causal relationship to PCT-PLT transfusion. RESULTS Over the course of 7 years in the study centres, 4067 patients received 19,175 PCT-PLT transfusions. Adverse events were infrequent, and most were of Grade 1 severity. On a per-transfusion basis, 123 (0.6%) were classified an acute transfusion reaction (ATR) defined as an adverse event related to the transfusion. Among these ATRs, the most common were chills (77, 0.4%) and urticaria (41, 0.2%). Fourteen SAEs were reported, of which 2 were attributed to platelet transfusion (<0.1%). No case of transfusion-related acute lung injury, transfusion-associated graft-versus-host disease, transfusion-transmitted infection or death was attributed to the transfusion of PCT-PLT. CONCLUSION This longitudinal haemovigilance safety programme to monitor PCT-PLT transfusions demonstrated a low rate of ATRs, and a safety profile consistent with that previously reported for conventional platelet components.
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Affiliation(s)
- F Knutson
- Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
| | - J Osselaer
- Cliniques Universitaires de Mont Godinne, Universite Catholique de Louvain, Yvoir, Belgium
| | - L Pierelli
- Department of Experimental Medicine, Sapienza University of Roma, Rome, Italy
| | - M Lozano
- Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - J Cid
- Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | | | - O Garraud
- EFS Auvergne Loire, St. Etienne, France
| | - T Hervig
- Department of Immunology and Transfusion Medicine, University of Bergen, Bergen, Norway
| | - D Domanovic
- Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
| | - M Cukjati
- Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
| | - S Gudmundson
- Blood Bank, National University Hospital, Reykjavik, Iceland
| | | | - A Castrillo
- Transfusion Centre of Galicia, Santiago de Compostela, Spain
| | - R Gonzalez
- Transfusion Centre of Galicia, Santiago de Compostela, Spain
| | - D Brihante
- Servico de Imuno-Hemoterapia, Instituto Portugues de Oncologia de Lisboa, Lisbon, Portugal
| | - M Santos
- Servico de Imuno-Hemoterapia, Instituto Portugues de Oncologia de Lisboa, Lisbon, Portugal
| | - P Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | | | - J-S Lin
- Cerus Corporation, Concord, CA, USA
| | - D Tappe
- Cerus Corporation, Concord, CA, USA
| | | | - J Green
- Cerus Corporation, Concord, CA, USA
| | - L Corash
- Cerus Corporation, Concord, CA, USA
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Donnet T, Ravanat C, Eckly A, Maurer E, Alame G, Ziessel C, Mangin PH, Freund M, Cazenave JP, Gachet C, Rendu F. Dehydration of blood platelets by zeodration: in vitro characterization and hemostatic properties in vivo. Transfusion 2015; 55:2207-18. [DOI: 10.1111/trf.13121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 02/23/2015] [Accepted: 02/28/2015] [Indexed: 12/13/2022]
Affiliation(s)
- Thibault Donnet
- UMR_S949 EFS Alsace; INSERM, Université De Strasbourg; Strasbourg
- Faculté De Médecine Pitié-Salpêtrière; UMR_S956 INSERM, UPMC; Paris France
| | | | - Anita Eckly
- UMR_S949 EFS Alsace; INSERM, Université De Strasbourg; Strasbourg
| | - Eric Maurer
- UMR_S949 EFS Alsace; INSERM, Université De Strasbourg; Strasbourg
| | - Ghina Alame
- UMR_S949 EFS Alsace; INSERM, Université De Strasbourg; Strasbourg
| | | | - Pierre H. Mangin
- UMR_S949 EFS Alsace; INSERM, Université De Strasbourg; Strasbourg
| | - Monique Freund
- UMR_S949 EFS Alsace; INSERM, Université De Strasbourg; Strasbourg
| | | | - Christian Gachet
- UMR_S949 EFS Alsace; INSERM, Université De Strasbourg; Strasbourg
| | - Francine Rendu
- Faculté De Médecine Pitié-Salpêtrière; UMR_S956 INSERM, UPMC; Paris France
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Harvey AR, Basavaraju SV, Chung KW, Kuehnert MJ. Transfusion-related adverse reactions reported to the National Healthcare Safety Network Hemovigilance Module, United States, 2010 to 2012. Transfusion 2014; 55:709-18. [PMID: 25371300 DOI: 10.1111/trf.12918] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/11/2014] [Accepted: 09/12/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND In 2010, health care facilities in the United States began voluntary enrollment in the National Healthcare Safety Network (NHSN) Hemovigilance Module. Participants report transfusion practices; red blood cell, platelet (PLT), plasma, and cryoprecipitate units transfused; and transfusion-related adverse reactions and process errors to the Centers for Disease Control and Prevention through a secure, Internet-accessible surveillance application available to transfusing facilities. STUDY DESIGN AND METHODS Facilities submitting at least 1 month of transfused components data and adverse reactions from January 1, 2010, to December 31, 2012, were included in this analysis. Adverse reaction rates for transfused components, stratified by component type and collection and modification methods, were calculated. RESULTS In 2010 to 2012, a total of 77 facilities reported 5136 adverse reactions among 2,144,723 components transfused (239.5/100,000). Allergic (46.8%) and febrile nonhemolytic (36.1%) reactions were most frequent; 7.2% of all reactions were severe or life-threatening and 0.1% were fatal. PLT transfusions (421.7/100,000) had the highest adverse reaction rate. CONCLUSION Adverse transfusion reaction rates from the NHSN Hemovigilance Module in the United States are comparable to early hemovigilance reporting from other countries. Although severe reactions are infrequent, the numbers of transfusion reactions in US hospitals suggest that interventions to prevent these reactions are important for patient safety. Further investigation is needed to understand the apparent increased risk of reactions from apheresis-derived blood components. Comprehensive evaluation, including data validation, is important to continued refinement of the module.
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Affiliation(s)
- Alexis R Harvey
- Office of Blood, Organ and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging, Zoonotic, and Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sridhar V Basavaraju
- Office of Blood, Organ and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging, Zoonotic, and Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Koo-Whang Chung
- Office of Blood, Organ and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging, Zoonotic, and Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Matthew J Kuehnert
- Office of Blood, Organ and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging, Zoonotic, and Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
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Martinaud C, Chastagnet N, Sailliol A, de Jaureguiberry JP, Aguilon P. Évaluation des pratiques transfusionnelles plaquettaires. Transfus Clin Biol 2012; 19:25-31. [DOI: 10.1016/j.tracli.2011.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 08/04/2011] [Indexed: 10/14/2022]
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Sousa Neto ALD, Barbosa MH. Incidentes transfusionais imediatos: revisão integrativa da literatura. ACTA PAUL ENFERM 2012. [DOI: 10.1590/s0103-21002012000100025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo de revisão integrativa da literatura teve como objetivo analisar as pesquisas que abordam a ocorrência de incidentes transfusionais imediatos e ações de hemovigilância implantadas. Os dados foram obtidos por meio de busca nas bases de dados - LILACS, MEDLINE e PUBMED - abrangendo o período de 1980 a 2009, nos idiomas português, inglês e espanhol. Foram identificados 1.382 artigos, dos quais 29 atenderam aos critérios de inclusão estabelecidos. Destes artigos, 20 (69,0%) eram estudos retrospectivos transversais, 8 (27,5%) prospectivos e um (3,5%) caso-controle. Em relação à abordagem, os estudos foram classificados em dois focos temáticos: tipos de incidentes transfusionais imediatos e ações de hemovigilância implantadas associadas aos tipos de incidentes transfusionais imediatos. A análise dos trabalhos destacou a maior ocorrência de reação febril não hemolítica e alérgica, avanço em ações de hemovigilância e maior preocupação com a qualidade da assistência hemoterápica.
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Andreu G, Vasse J, Tardivel R, Semana G. Transfusion de plaquettes : produits, indications, dose, seuil, efficacité. Transfus Clin Biol 2009; 16:118-33. [DOI: 10.1016/j.tracli.2009.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Accepted: 04/01/2009] [Indexed: 10/20/2022]
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