Hemostatic function of apheresis platelets stored at 4°C and 22°C.
Hemostatic function of apheresis platelets stored at 4°C and 22°C.
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DOI：
10.1097/shk.0000000000000082
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发表时间：
2014-05
期刊：
影响因子：
--
通讯作者：
Cap AP
中科院分区：
文献类型：
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作者：
Reddoch KM;Pidcoke HF;Montgomery RK;Fedyk CG;Aden JK;Ramasubramanian AK;Cap AP
血小板冷藏降低了细菌污染的风险，并且可能比标准护理室温储存更好地保存功能。其益处包括降低输血相关并发症、降低成本、改善急性出血患者的止血效果以及延长保质期。在这项研究中，我们比较了22°C和4°C储存对单采血小板（AP）功能和活化状态的影响。将AP（每组n = 5）在22°C搅拌（RT）下储存5天，相对于在4°C搅拌（4C+AG）和不搅拌（4C）下储存5天。测量包括血小板计数、平均血小板体积、血气分析、聚集反应、血栓弹力图、TxB 2和sCD 40 L释放、活化标志物和微粒形成。样品pH值水平在储存产品的可接受限度内（pH 6.2-7.4）。与RT储存相比，血小板葡萄糖代谢（P < 0.05）、聚集反应（ADP：RT 0; 4C+AG 5.0 ± 0.8; 4C 5.6 ± 0.9; P < 0.05）和凝块强度（MA：RT 58 ± 2; 4C+AG 63 ± 2; 4C 67 ± 2; P < 0.05）在4 ℃下保存得更好。冷冻样品比RT样品更活化（P < 0.05），尽管RT时TxB 2（P < 0.05）和sCD 40 L释放（P < 0.05）更高。搅拌不能改善4° C储存样品的质量。在4°C下储存的AP保持更有活力的代谢特征，止血更有效，并且比在RT下储存5天的AP释放更少的促炎介质。鉴于冷藏产品的上级细菌学安全性，这些数据表明，冷藏血小板可能会改善急性出血患者的预后。
Platelet refrigeration decreases the risk of bacterial contamination and may preserve function better than standard-of-care room temperature storage. Benefits could include lower transfusion-related complications, decreased costs, improved hemostasis in acutely bleeding patients, and extended shelf-life. In this study, we compared the effects of 22°C and 4°C storage on the functional and activation status of apheresis platelets (APs). APs (n = 5 per group) were stored for 5 days at 22°C with agitation (RT) versus at 4°C with agitation (4C+AG) and without (4C). Measurements included platelet counts, mean platelet volume, blood gas analytes, aggregation response, thromboelastography, TxB2 and sCD40L release, activation markers and microparticle formation. Sample pH levels were within acceptable limits for storage products (pH 6.2-7.4). Platelet glucose metabolism (P < 0.05), aggregation response (ADP: RT 0; 4C+AG 5.0 ± 0.8; 4C 5.6 ± 0.9; P < 0.05), and clot strength (MA: RT 58 ± 2; 4C+AG 63 ± 2; 4C 67 ± 2; P < 0.05) were better preserved at 4°C compared to RT storage. Refrigerated samples were more activated compared to RT (P < 0.05), although TxB2 (P < 0.05) and sCD40L release (P < 0.05) were higher at RT. Agitation did not improve the quality of 4°C-stored samples. AP stored at 4°C maintain more viable metabolic characteristics, are hemostatically more effective, and release fewer pro-inflammatory mediators than AP stored at RT over 5 days. Given the superior bacteriologic safety of refrigerated products, these data suggest that cold-stored platelets may improve outcomes for acutely bleeding patients.