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The quality of platelet concentrates produced by COBE Spectra and Trima Accel during storage for 7 days as assessed by in vitro methods
Linköping University, Department of Clinical and Experimental Medicine, Transfusion Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
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2008 (English)In: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Vol. 48, no 4, 715-722 p.Article in journal (Refereed) Published
Abstract [en]

Background: The quality of PLT concentrates (PCs) can be evaluated using various in vitro methods. A new technique, free oscillation rheometry (FOR), can be used to monitor coagulation properties of PCs and gives information on clotting time and coagulum elasticity. This study compared the quality of apheresis PCs produced by COBE Spectra and Trima Accel during storage for 7 days using in vitro tests including FOR.

Study design and methods: Apheresis PCs were collected with the COBE Spectra (n=10) and Trima Accel (n=10) cell separators. Swirling, blood gases and metabolic parameters were analyzed on day 0. Samples taken on day 1, 5 and 7 were also analyzed for hypotonic shock response (HSR), P-selectin and GPIb expression and evaluation of coagulation by FOR.

Results: Swirling, HSR and percent GPIb expressing PLTs were well maintained for 7 days whereas glucose decreased and lactate increased significantly during storage for both Spectra and Trima PCs. Percent P-selectin expressing cells increased to the same extent in both types of PCs during storage. pH increased between day 0 and 1 but then decreased. The clotting time remained constant throughout the storage period whereas the development of elasticity was reduced on day 5 and 7 compared to day 1 (p<0.05) for both types of PCs.

Conclusion: The results indicate that the PLT quality after storage for 7 days is well preserved although activation of PLTs occurs during storage as assessed by in vitro tests. No difference in platelet quality was observed between Spectra and Trima produced PCs.

Place, publisher, year, edition, pages
2008. Vol. 48, no 4, 715-722 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-12533DOI: 10.1111/j.1537-2995.2007.01610.xOAI: oai:DiVA.org:liu-12533DiVA: diva2:434
Note
The definitive version is available at www.blackwell-synergy.com: Nahreen Tynngård, Tomas L. Lindahl, Marie Trinks, Monika Studer and Gösta Berlin, The quality of platelet concentrates produced by COBE Spectra and Trima Accel during storage for 7 days as assessed by in vitro methods, 2008, Transfusion, (48), 4, 715-722. Copyright: Blackwell Publishing www.blackwell-synergy.comAvailable from: 2008-09-08 Created: 2008-09-12 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Free oscillation rheometry in the assessment of platelet quality
Open this publication in new window or tab >>Free oscillation rheometry in the assessment of platelet quality
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Platelets play an important role in the haemostatic process in order to seal damaged blood vessels. The platelets form a platelet plug at the damaged area and prevent blood loss. Once the damage to the vessel wall has been covered, the platelets retract the coagulum, to allow the blood to flow freely in the vessel. Free oscillation rheometry (FOR) can be used for analysis of coagulation as measured by clotting time and changes in clot elasticity (G'). Clot G' provides information about the fibrin network in the coagulum and the platelets’ ability to retract the coagulum. FOR analysis is performed using the ReoRox® 4 instrument. The blood sample is added to a cylindrical sample cup, which is set into free oscillation. The frequency and damping of the oscillation is recorded over time as the blood coagulates. The change in G' is calculated from the frequency and damping measured. Patients with malignant haematological diseases are often thrombocytopaenic and require platelet transfusions to prevent or stop bleeding. To ensure good haemostatic function in the recipient it is important that the quality of the platelets used for transfusion is well preserved. The aim of this thesis was to determine the quality of platelet concentrates (PCs), during storage, using various in vitro methods, including FOR, and to investigate how various preparation processes affect the quality. We also investigated whether FOR can be used to evaluate the haemostatic status in subjects at risk for thrombosis or bleeding as well as how the haemostatic status was affected by a platelet transfusion.

We show that FOR can provide information about the coagulation properties in subjects at risk of thrombosis (pregnant women) or bleeding (thrombocytopaenic patients). We also show that the coagulation as measured by FOR is influenced by red blood cells and the fibrinogen concentration. However, the presence of functional platelets accounted for 90% of the G'. Furthermore we present data that FOR can provide information on the haemostatic effect of platelet transfusions and on the function of the transfused platelets.

PCs produced by two different cell separators showed similar quality during storage for 7 days as assessed by FOR analysis. Leukocytes in the PCs can cause transfusion-associated graft-versus-host disease which can be prevented by gamma irradiation of the PCs. Gamma irradiation did not affect the quality of PCs during 7 days of storage as analysed by FOR. The clotting time was unchanged during the storage period. The capacity of platelets to retract the coagulum was reduced from days 1 to 5 of storage as seen by a prolonged time to reach maximum G' and the reduced mean change in G' per minute. However, if sufficient time is allowed for the platelets to regain their function, the clot will be fully retracted (as seen by a well maintained maximum G'). The FOR parameters were similar for 5- and 7-day old PCs, which, combined with other in vitro tests (e.g. hypotonic shock response, changes in pH, swirling, lactate and glucose), support the prolongation of the platelet storage period to 7 days. Intercept treatment of PCs can be performed to inhibit replication of contaminating bacteria in PCs. Intercept treatment of PCs did not diminish the clot-promoting capacity of the platelets as assessed by FOR clotting time.

In conclusion, FOR is a promising method for assessing hyper- and hypocoagulability. It can provide information on the haemostatic effect of platelet transfusions and the function of the transfused platelets. FOR was also shown to be useful for analysing PC quality during different preparation and storage conditions.

Place, publisher, year, edition, pages
Linköping University Electronic Press, 2008. 53 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1056
Keyword
Coagulation, elasticity, platelets, rheology, transfusion
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-11525 (URN)978-91-7393-935-5 (ISBN)
Public defence
2008-05-08, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 13:00 (English)
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Supervisors
Available from: 2008-04-14 Created: 2008-04-14 Last updated: 2015-11-19

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Tynngård, NahreenLindahl, TomasBerlin, Gösta

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