In vivo viability of extended 4°C-stored autologous apheresis platelets
In vivo viability of extended 4°C-stored autologous apheresis platelets
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DOI：
10.1111/trf.14833
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发表时间：
2018-10-01
期刊：
影响因子：
2.9
通讯作者：
Slichter, Sherrill J.
中科院分区：
文献类型：
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作者：
Stolla, Moritz;Fitzpatrick, Lynda;Slichter, Sherrill J.
目前室温（22℃）储存血小板（RSPs）的5天储存时间严重限制了血小板（PLT）的可用性。目前正在研究延长冷（4摄氏度）储存的血小板（CSPs）用于活动性出血患者。然而，我们目前还不知道如何最好地在低温下长时间储存plt。在这项研究中，我们研究了血浆和PLT添加剂溶液（PASs）的储存如何影响PLT在体内的活力。研究设计与方法20例正常受试者进行2单位高浓度单采PLT采集。一个单元在4摄氏度的血浆中保存3天（对照单元），CSP测试单元在血浆中保存10或15天，或在35%的血浆中保存10天，其中65% Intersol或Isoplate。储存后，所有的单位都被放射性标记并输注到它们的供体中。结果10 d时，血浆和Intersol的PLT回收率均显著高于Isoplate（24% 8%比11% +/- 3%[55% +/- 11%比21% +/- 8%为对照数据百分比]，p = 0.002； 18% +/- 4%比11% +/- 3%[43% +/- 6%比21% +/- 8%为对照数据百分比]，p = 0.004）。与血浆相比，Intersol有较低PLT回收率的趋势（p = 0.056）。PLT存活和大多数体外测量在不同单位之间没有显著差异。结论血浆与PASs的体外指标具有可比性，血浆的体内回收率高于Intersol和Isoplate （p = 0.057和p = 0.002）。这种差异是否会导致止血疗效的临床相关差异仍有待确定。
BACKGROUNDThe current 5-day storage time of room temperature (22 degrees C)-stored platelets (RSPs) severely limits platelet (PLT) availability. Extended cold (4 degrees C)-stored PLTs (CSPs) are currently being investigated for actively bleeding patients. However, we currently do not know how to best store PLTs in the cold for extended periods of time. In this study, we investigate how storage in plasma and PLT additive solutions (PASs) affects PLT viability in vivo.STUDY DESIGN AND METHODSTwenty normal subjects had a 2-unit hyperconcentrated apheresis PLT collection. One unit was stored at 4 degrees C in plasma for 3 days (control unit), and the CSP test unit was stored for 10 or 15 days in plasma or 10 days in 35% plasma with either 65% Intersol or Isoplate. After storage, all units were radiolabeled and transfused into their donors.RESULTSFor 10-day storage, both the plasma and the Intersol units had significantly better PLT recoveries than the Isoplate units (24% 8% vs. 11% +/- 3% [55% +/- 11% vs. 21% +/- 8% as percentage of control data], p = 0.002; and 18% +/- 4% vs. 11% +/- 3% [43% +/- 6% vs. 21% +/- 8% as percentage of control data], p = 0.004, respectively). There was a trend for lower PLT recoveries with Intersol compared to plasma (p = 0.056). PLT survivals and most in vitro measurements did not differ significantly among the units.CONCLUSIONSWhile the in vitro variables suggest largely comparable results between plasma and PASs, in vivo recoveries were higher with plasma compared with both Intersol and Isoplate (p = 0.057 and p = 0.002, respectively). Whether this difference leads to clinically relevant differences in hemostatic efficacy remains to be determined.