Original article: evaluation of platelet function by flow cytometric measurement of ligand binding

Rapid and relevant evaluation of platelet function is often clinically important. By means of fluorescent labelled chicken antibodies (which do not bind to Fc-receptors) against fibrinogen and von Willebrand factor and flow cytometry, we have determined the time course of ligand association to platelets after stimulation with adenosine 5'-diphosphate and ristocetin respectively. The expression of guanosine 5'-phosphate (GMP)-140 was also measured. We have applied this technique to evaluate platelet function during platelet storage and cardiopulmonary bypass. There was a significant reduction of the binding of fibrinogen and von Willebrand factor and significantly increased expression of GMP-140 after 9 days of storage. Changes in metabolic variables such as lactate accumulation, glucose consumption and decrease in pH confirm that the functional impairment is due to a large extent to a deteriorated platelet metabolism. No significant differences were found between samples taken before and during cardiopulmonary bypass, but there was a tendency towards increased ligand binding as well as increased expression of GMP-140 at the end of cardiopulmonary bypass. The flow cytometric technique that is described may be useful for evaluation of platelet function and platelet activation in vivo.