Platelets stored at 4°C contribute to superior clot properties compared to current standard-of-care through fibrin-crosslinking.
Platelets stored at 4°C contribute to superior clot properties compared to current standard-of-care through fibrin-crosslinking.
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DOI：
10.1111/bjh.14751
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发表时间：
2017-07
影响因子：
6.5
通讯作者：
Ramasubramanian AK
中科院分区：
文献类型：
--
作者：
Nair PM;Pandya SG;Dallo SF;Reddoch KM;Montgomery RK;Pidcoke HF;Cap AP;Ramasubramanian AK
目前，用于输注的血小板在室温（RT）下储存5-7天，并轻轻搅拌，但由于功能丧失和细菌污染的风险，这不是最佳的。我们之前已经证明，冷（4°C）储存是一种有吸引力的替代方案，因为它比RT储存更好地保留了血小板代谢储备，对激活，聚集和生理抑制剂激动剂的体外反应，以及对血栓形成表面的粘附。最近，美国食品和药物管理局澄清，在4°C下储存长达72小时的单采血小板可用于治疗活动性出血。在这项工作中，我们测试的假设，即冷储存的血小板有助于产生具有上级的机械性能相比，RT储存的血小板凝块。流变学研究表明，由在4°C下储存5天的血小板形成的凝块比由RT储存的血小板形成的凝块显著更硬（更高的弹性模量）和更强（更高的临界应力）。形态学分析表明，冷藏血小板的凝块纤维比室温保存血小板的凝块纤维更致密、更细、更直、有更多的分支点或交联点。我们的研究结果还表明，增强的凝块强度和包装结构是由于冷诱导的血浆因子XIII结合到血小板表面，以及随之而来的交联增加。
Currently, platelets for transfusion are stored at room temperature (RT) for 5–7 days with gentle agitation, but this is less than optimal because of loss of function and risk of bacterial contamination. We have previously demonstrated that cold (4°C) storage is an attractive alternative because it preserves platelet metabolic reserves, in vitro responses to agonists of activation, aggregation and physiological inhibitors, as well as adhesion to thrombogenic surfaces better than RT storage. Recently, the US Food and Drug Administration clarified that apheresis platelets stored at 4°C for up to 72 h may be used for treating active haemorrhage. In this work, we tested the hypothesis that cold-stored platelets contribute to generating clots with superior mechanical properties compared to RT-stored platelets. Rheological studies demonstrate that the clots formed from platelets stored at 4°C for 5 days are significantly stiffer (higher elastic modulus) and stronger (higher critical stress) than those formed from RT-stored platelets. Morphological analysis shows that clot fibres from cold-stored platelets were denser, thinner, straighter and with more branch points or crosslinks than those from RT-stored platelets. Our results also show that the enhanced clot strength and packed structure is due to cold-induced plasma factor XIII binding to platelet surfaces, and the consequent increase in crosslinking.