Effects of Intercept pathogen reduction treatment on extended cold storage of apheresis platelets
Effects of Intercept pathogen reduction treatment on extended cold storage of apheresis platelets
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DOI：
10.1111/trf.16096
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发表时间：
2020-12-08
期刊：
影响因子：
2.9
通讯作者：
Bynum, James
中科院分区：
文献类型：
--
作者：
Agey, Alisa;Reddoch-Cardenas, Kristin;Bynum, James
背景血小板是血液制品中最大的输血传播感染风险。冷藏血小板可减轻细菌污染并延长血小板保存期。在血库实施病原体减少技术（PRT）已变得越来越受欢迎，以防止新出现和重新出现的传染病。在本研究中，我们试图评估Intercept PRT对在不同平台上采集的血小板的影响，并在血浆和血小板添加剂溶液（PAS）中冷藏长达21天。方法使用Trima或Amicus系统采集双倍剂量单采血小板，置于100%血浆或65% InterSol PAS/35%血浆中，并在两个袋中平均分配。一个袋作为对照，而另一个袋接受Intercept PRT处理。将袋储存在寒冷中不搅动，并在第1天，第7天，第14天和第21天进行评估，以评估血小板代谢，活化，聚集，凝块形成和retraction.Results的第14天的存储，乳酸水平达到约13 mmol/L的所有样品，无论拦截治疗。平均血凝块硬度从62.2- 67.5 mm范围（第1天）降至28.4- 51.3 mm范围（第21天），未观察到组间差异。到储存第14天，Intercept处理的Trima/血浆样本的凝块重量显著高于对照品（P = .004），表明凝块收缩功能降低。Intercept治疗引起了较高的发生率，血浆储存的血小板（P = .0013; Trima/血浆第14天控制与Intercept）。结论血小板和随后的冷藏，在血浆或PAS中，Intercept治疗，结果相当的血小板代谢血小板储存长达14天，但凝血动力学改变。减少病原体且保质期延长的血小板将有利于部署环境，并将极大地影响民用输血中心的输血实践。
Background Platelets pose the greatest transfusion-transmitted infectious risk among blood products. Refrigeration of platelets can mitigate bacterial contamination and extend platelet shelf life. Implementation of pathogen reduction technologies (PRTs) at blood banks has become increasingly popular to protect against emerging and reemerging infectious diseases. In this study, we sought to evaluate the effects of Intercept PRT on platelets collected on different platforms and cold-stored for up to 21 days in plasma and platelet additive solution (PAS).Methods Double-dose apheresis platelets were collected with use of a Trima or Amicus system into either 100% plasma or 65% InterSol PAS/35% plasma and split equally between two bags. One bag served as control, while the other received Intercept PRT treatment. Bags were stored unagitated in the cold and evaluated on Days 1, 7, 14, and 21 to assess platelet metabolism, activation, aggregation, and clot formation and retraction.Results By Day 14 of storage, lactate levels reached approximately 13 mmol/L for all samples irrespective of Intercept treatment. Mean clot firmness dropped from the 62.2- to 67.5-mm range (Day 1) to the 28.4- to 51.3-mm range (Day 21), with no differences observed between groups. Clot weights of Intercept-treated Trima/plasma samples were significantly higher than control by Day 14 of storage (P = .004), indicating a reduced clot retraction function. Intercept treatment caused a higher incidence of plasma membrane breakdown in plasma-stored platelets (P = .0013; Trima/plasma Day 14 Control vs Intercept).Conclusions Intercept treatment of platelets and subsequent cold storage, in plasma or PAS, results in comparable platelet metabolism platelets for up to 14 days of storage but altered clotting dynamics. Pathogen-reduced platelets with an extended shelf life would be beneficial for the deployed setting and would greatly impact transfusion practice among civilian transfusion centers.