Clinical and quality evaluation of apheresis vs random-donor platelet concentrates stored for 7 days

The clinical efficacy of different types of platelets remains under debate. We conducted a pilot study to prospectively evaluate the impact of subsequent storage on the in vitro quality and post-transfusion outcome of apheresis prepared platelets (APCs) vs random donor platelets (RDPs).

We studied 30 units of APCs, and 30 units of RDPs. We performed assays on days 1, 3, 5 and 7, evaluating ADP aggregation, platelet count and pH. Fifteen thrombocytopenic patients with haematologic conditions were evaluated. Each patient received prophylactic transfusions of both components, and their post-transfusion platelet increments were compared. Twenty-five transfusions were apheresis prepared, and 35 transfusions were received as RDPs. None of the RDPs were leukoreduced.

The median platelet counts for APCs on days 1, 3, 5 and 7 were; 2070, 1990, 1680 and 1240 × 10(3)  µL(-1) , respectively, and were; 1290, 850, 499 and 284 × 10(3)  µL(-1) , respectively for RDPs. The pH of all units was more than 6·2. Both groups demonstrated a significant decrease of ADP aggregation after 3 days of storage (P < 0·05). However, APCs provided satisfactory increments for 90·9% of transfusions. On the sixth and seventh days of storage, APCs provided significantly higher platelet increments (18·7 × 10(3)  µL(-1) ) compared with RDPs (3·20 × 10(3)  µL(-1) ) (P < 0·05). Significantly longer transfusion intervals were also achieved with APCs (P < 0·05).

Although other variables may have confounded the results, subsequent storage of APCs appeared to provide higher increments with longer intervals of transfusion compared with RDPs. Future prospective studies are needed, adjusting for other possible confounding variables.