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Storage of pooled platelet concentrates. In vitro and in vivo analysis
E L Snyder1, G Stack, P Napychank
1Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut.
Insights
Pooling platelet concentrates (PCs) using sterile connecting devices allows for up to 5-day storage. This study found pooled PCs maintained acceptable in vitro storage and showed comparable in vivo recovery to unpooled platelets without lymphocyte activation.
Area of Science:
- Transfusion Medicine
- Hematology
- Blood Component Storage
Background:
- Sterile connecting devices enable extended storage of pooled platelet concentrates (PCs).
- Limited data exists on the long-term storage efficacy and safety of PCs pooled from multiple donors.
Purpose of the Study:
- To evaluate the in vitro storage characteristics and in vivo recovery of pooled platelet concentrates (PCs) stored for up to 5 days.
- To assess the potential for passenger lymphocyte activation within pooled PCs during storage.
Main Methods:
- Four units of ABO-compatible or -incompatible PCs were pooled and stored in PL-732 bags for up to 5 days.
- In vitro assays assessed storage values, pH, and lymphocyte activation markers (T-cell activation, 3H thymidine uptake).
- In vivo studies transfused 4-unit pools of ABO-compatible PCs (stored up to 96 hours) into thrombocytopenic patients to determine correct count increments (CCI).
Main Results:
- In vitro assays demonstrated acceptable storage values for pooled PCs, irrespective of ABO compatibility, comparable to unpooled controls.
- Pool pH on Day 5 was 6.83 +/- 0.3.
- In vivo studies showed a mean 1-hour CCI of 11,368 for pooled platelets versus 7819 for unpooled controls (p > 0.05).
- No evidence of activated T-cell markers or 3H thymidine uptake was observed in lymphocytes from stored pooled PCs.
Conclusions:
- Pooled platelet concentrates (PCs) can be stored for up to 5 days with acceptable in vitro quality.
- Pooled PCs demonstrate comparable in vivo recovery to unpooled platelets.
- Passenger lymphocyte activation is not a significant concern during the storage of pooled PCs.
Abstract:
The use of sterile connecting devices will permit up to 5-day storage of pooled platelet concentrates (PCs). However, there are no data evaluating long-term storage of PCs pooled from multiple donors. Four units of ABO-compatible or -incompatible PCs were pooled and stored in single 300-ml PL-732 storage bags for up to 5 days. Results of in vitro assays showed acceptable storage values regardless of the ABO types in the pool. Pool pH on Day 5 was 6.83 +/- 0.3 (mean +/- 1 SD). The in vitro storage characteristics were comparable to those of unpooled age-matched platelets reported previously from our laboratory. For in vivo studies, 4-unit pools of ABO-compatible random-donor PCs stored for up to 96 hours in 1000-ml PL-732 bags were transfused into patients who were thrombocytopenic due to bone marrow failure, and the correct count increments (CCI) were determined. In vivo results showed a mean 1-hour CCI of 11,368 +/- 5824 for the pooled stored platelets and 7819 +/- 5189 for unpooled controls (p greater than 0.05). To evaluate the possibility that passenger lymphocytes in the concentrates would generate mixed lymphocyte reactions (MLR) in the pooling bag during storage, lymphocytes were studied over 5 days of storage by the use of monoclonal antibodies against activated T-cell markers and by 3H thymidine uptake. Results failed to show evidence of either the generation of activated T-cell markers or the uptake of 3H thymidine.(ABSTRACT TRUNCATED AT 250 WORDS)