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Published on: December 7, 2012
Storage of platelets at 4°C in platelet additive solutions prevents aggregate formation and preserves platelet
Todd M Getz1, Robbie K Montgomery1, James A Bynum1
1US Army Institute of Surgical Research, Fort Sam Houston, San Antonio, Texas.
Insights
Storing platelets in platelet additive solution (PAS) at 4°C prevents cold-induced platelet aggregation and preserves function, offering a viable alternative to room temperature storage.
Area of Science:
- Transfusion Medicine
- Hematology
- Biotechnology
Background:
- Platelet (PLT) storage is limited to 5 days at room temperature due to metabolic issues and contamination risks.
- Refrigeration improves PLT metabolism and limits bacterial growth but causes cold-induced aggregate formation.
- This study investigates the mechanism of cold-induced PLT aggregation and potential prevention strategies.
Purpose of the Study:
- To investigate the hypothesis that cold storage of platelets in plasma (AP) induces glycoprotein (GP)IIb-IIIa activation and aggregation.
- To determine if storing platelets in platelet additive solution (PAS) at 4°C can prevent aggregation without compromising function.
- To evaluate the impact of different storage conditions on platelet viability and function over 15 days.
Main Methods:
- Apheresis platelets in plasma (AP) and PAS were stored at 22°C or 4°C for up to 15 days.
- Evaluated platelet counts, blood gases, aggregation responses, and flow cytometry for integrin levels, activation markers, and microparticle formation.
Main Results:
- Storage of AP at 4°C led to decreased platelet counts and increased aggregate formation via calcium leak and fibrinogen receptor activation.
- Storage of PAS at 4°C prevented aggregate formation by diluting plasma fibrinogen.
- PAS stored at 4°C maintained better aggregation responses compared to 22°C controls.
Conclusions:
- Cold storage of AP induces low-level GPIIb-IIIa activation, leading to platelet aggregation over time.
- Storing platelets in PAS at 4°C effectively prevents cold-induced aggregation.
- This method preserves the metabolic and functional responses of stored platelets, extending their viability.
Background:
Platelet (PLT) storage has been limited to 5 days at room temperature due to metabolic decline and risk for bacterial contamination. Refrigeration preserves PLT metabolism and function as well as limits bacterial growth; however, cold storage of PLTs also leads to aggregate formation. We hypothesized that storage of PLT concentrates at 4°C leads to glycoprotein (GP)IIb-IIIa activation and thus aggregate formation through fibrinogen binding and that this could be prevented by storing PLTs in PLT additive solution (PAS) without compromising PLT function.
Study Design And Methods:
Apheresis PLTs in plasma (AP) or apheresis PLTs in PAS were stored at 22 or 4°C for up to 15 days. Measurements include PLT counts, blood gases, aggregation response, flow cytometry analysis of integrin levels, activation markers, and microparticle formation.
Results:
Storage of AP 4°C led to a gradual decline in PLT count and an increase in aggregate formation that was mediated by intracellular calcium leak and fibrinogen receptor activation. Storage of PAS at 4°C prevented aggregate formation due to dilution of plasma fibrinogen. PAS stored at 4°C maintained aggregation responses to multiple agonists better than 22°C controls.
Conclusion:
Storage of AP at 4°C leads to low level GPIIb-IIIa activation and results in aggregate formation over time. Separating the PLTs from the plasma component and storing them in PAS at 4°C resolves aggregate formation and preserves the metabolic and functional responses of these stored PLTs.
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