Platelet Storage Conditions

Under physiological conditions, the change in shape of platelets is a decisive event for their proper functioning: this phenomenon consists of a global remodeling of the actin cytoskeleton with destruction of already existing actin filaments and simultaneous construction of new actin monomer units. This event leads to the transformation of discoid platelets into spiny balls. 45. Submitted by the Working Party on Blood of the Federal Ministry of Health. Supplement to Vote 38: Reduce the risk of sepsis by using platelet concentrates. edoc.rki.de/bitstream/handle/176904/106/29wmzUschTXdbM.pdf?sequence=1&isAllowed=y. Search in Google Scholar The vortex is a simple parameter for assessing platelet morphology and can be evaluated with the naked eye. It must be carried out after the manufacture of the product and before distribution. Bertolini and colleagues identified a decrease in turbulence in platelet concentrates as a signal for the transition from disc to sphere in platelet morphology, which is considered a typical sign of a storage lesion [60]. Since platelet morphology is considered one of the most important physical parameters indicating the ability of platelets to circulate in the blood, and given the simplicity of the swirling evaluation, it is recommended that doctors evaluate platelet morphology just before transfusion.

However, since the platelet preparation has changed significantly (e.g., platelet additive solutions, gas permeable bags), the absence of turbulence is rarely observed and, if it occurs, should be treated with caution, as it could be a sign of bacterial contamination or malpractice. At the same time, SBPs have been studied, as they have been found to reduce plasma demand and allergic transfusion reactions. PAS are compatible with room temperature storage, although investigators used PAS for cold and room temperature storage. So far, research has shown some success. By the end of the century, the concept of platelet progeny was developed and in vitro studies were apparently positive, but the concept requires much more research before platelets can be manufactured on demand, which would reduce the need for storage. Proteomics provides basic knowledge about the biological functions of platelets. This knowledge should lead to a new perspective on PSL, encompassing multiple pathways to a common understanding, potentially leading to new ideas for platelet storage. 26. Kaufman, RM. Unusual cold: Could storing 4°C improve platelet function? Transfusion 2005;45:1407–12. doi.org/10.1111/j.1537-2995.2005.00544.x.Search in Google Scholar PubMed Unfortunately, cold temperatures induce apoptosis through the arachidonic acid complex, where the released arachidonic acid decreases the potential of the mitochondrial membrane and ultimately induces apoptosis [5].

Arachidonic acid activates protein kinase C [14,15], which in turn inhibits nitric oxide [16], which leads to platelet activation [17]. By cooling PCs, they leave circulation a few hours after transfusion, as von Willebrand factor receptors (vWF) such as GPIbα are recognized by αMβ3-integrin and absorbed by macrophages [18]. The use of a mouse model has shown that a lack of αMβ3 integrin receptors helps maintain platelet circulation and promote their normal function [19]. In contrast, human in vivo studies have shown poor circulating survival, although they have had better function [19-21]. Therefore, the approach did not attract much attention, as subsequent studies did not produce consistent results. Several pathways are directly or indirectly involved or have synergistic or antagonistic effects on CPs during cold storage. Therefore, it is necessary to correlate our previous and existing knowledge in order to develop a modified method that is more reliable than current methods. The December 2020 platelet guideline recommends that blood collectors and transfusion services implement «bacterial risk control strategies» to mitigate the risk of septic transfusion reactions caused by platelets stored at room temperature.

The guide provides options to support the process from day 5 to day 7. Extending expiration beyond Day 5 to Day 7 requires the use of equipment labeled as a «safety measure» and FDA-approved or approved storage containers for 7-day storage. Welsby IJ, Lockhart E, Phillips-Bute B, Campbell ML, Mathew JP, Newman MF, Peterson E, Milano CA. Mark Stafford-Smith for members of the cardiothoracic anesthesia research DoADUMC: Storage age of transfused platelets and results after heart surgery. Transfusion. 2010;50(11):2311–7. The sum of the adverse reactions that occur during cold platelet storage is usually referred to as cold-induced storage lesions. One of the first visible effects of platelet damage is the irreversible loss of discoid morphology to a spherical shape and the appearance of spinous processes on the surface due to the activation of calcium-dependent gelsolin and phosphoinositide-mediated actin polymerization12.