Platelet Storage Lesions: What More Do We Know Now?

Area of Science:

• Transfusion Medicine
• Hematology
• Biochemistry

Background:

• Platelet concentrates (PCs) are vital for managing bleeding in various patient groups.
• Platelet storage lesions (PSLs) and bacterial contamination limit PC availability and safety.
• PSLs involve biochemical, structural, and functional changes during storage, affecting platelet efficacy.

Purpose of the Study:

• To review advancements in clinical and mechanistic research on platelet storage lesions (PSLs).
• To understand how PSLs affect platelet concentrate (PC) quality and clinical outcomes.
• To explore potential interventions for prolonging PC shelf life and improving access.

Main Methods:

• Review of clinical and mechanistic research on platelet storage lesions (PSLs).
• Analysis of biochemical and structural changes during PC preparation and storage.
• Examination of clinical data correlating stored PCs with transfusion outcomes.

Main Results:

• PC preparation and storage induce platelet activation, fragmentation, and biochemical release, initiating PSLs.
• Room temperature storage leads to glucose depletion, acidification, and impaired platelet function.
• Stored PCs show reduced corrected count increment, posttransfusion recovery, and survival; immunoactive proteins and microparticles accumulate.

Conclusions:

• Understanding PSLs is crucial for improving PC shelf life, access, and reducing wastage.
• Interventions like modified storage media, cryopreservation, and cold storage are being explored to mitigate PSLs.
• Further research is needed to manage PSLs associated with novel storage protocols before clinical implementation.