Refrigeration of apheresis platelets in platelet additive solution (PAS-E) supports in vitro platelet quality to maximize the shelf-life
Corresponding Author
Lacey Johnson
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Correspondence
Lacey Johnson, Research and Development, Australian Red Cross Lifeblood, 17 O'Riordan St, Alexandria, NSW, Australia.
Email: [email protected]
Search for more papers by this authorShuchna Vekariya
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Search for more papers by this authorBen Wood
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Search for more papers by this authorShereen Tan
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Search for more papers by this authorChristopher Roan
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Search for more papers by this authorDenese C. Marks
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
Search for more papers by this authorCorresponding Author
Lacey Johnson
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Correspondence
Lacey Johnson, Research and Development, Australian Red Cross Lifeblood, 17 O'Riordan St, Alexandria, NSW, Australia.
Email: [email protected]
Search for more papers by this authorShuchna Vekariya
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Search for more papers by this authorBen Wood
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Search for more papers by this authorShereen Tan
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Search for more papers by this authorChristopher Roan
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Search for more papers by this authorDenese C. Marks
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
Search for more papers by this authorAbstract
Background
Refrigeration, or cold-storage, of platelets may be beneficial to extend the limited shelf-life of conventionally stored platelets and support transfusion protocols in rural and military areas. The aim of this study was to compare the morphologic, metabolic, and functional aspects of apheresis platelets stored at room-temperature (RT) or cold conditions, in either plasma or supplemented with platelet additive solution (PAS).
Study design and methods
Double-dose apheresis platelets were collected in either 100% plasma or 40% plasma/60% PAS-E using the Trima apheresis platform. One component from each group was either stored at RT (20–24°C) or refrigerated (2–6°C). Platelets were tested over a 21-day period.
Results
The platelet concentration decreased by approximately 30% in all groups during 21 days of storage (p > .05). Cold-storage reduced glycolytic metabolism, and the pH was maintained above the minimum specification (>6.4) for 21 days only when platelets were stored in PAS. The surface phenotype and the composition of the supernatant were differentially affected by temperature and storage solution. Functional responses (aggregation, agonist-induced receptor activation, clotting time) were improved during cold-storage, and the influence of residual plasma was assay dependent.
Conclusion
In vitro platelet quality is differentially affected by storage time, temperature, and solution. Cold-storage, particularly in PAS, better maintains key metabolic, phenotypic, and functional parameters during prolonged storage.
CONFLICT OF INTEREST
The authors have disclosed no conflicts of interest.
REFERENCES
- 1Becker G, Tuccelli M, Kunicki T, Chalos M, Aster R. Studies of platelet concentrates stored at 22°C and 4°C. Transfusion. 1973; 13: 61–8.
- 2Ketter PM, Kamucheka R, Arulanandam B, Akers K, Cap AP. Platelet enhancement of bacterial growth during room temperature storage: mitigation through refrigeration. Transfusion. 2019; 59: 1479–89.
- 3Jenkins D, Stubbs J, Williams S, Berns K, Zielinski M, Strandenes G, et al. Implementation and execution of civilian remote damage control resuscitation programs. Shock. 2014; 41: 84–9.
- 4Sandgren P, Hansson M, Gulliksson H, Shanwell A. Storage of buffy-coat-derived platelets in additive solutions at 4°C and 22°C: flow cytometry analysis of platelet glycoprotein expression. Vox Sang. 2007; 93: 27–36.
- 5Johnson L, Tan S, Wood B, Davis A, Marks DC. Refrigeration and cryopreservation of platelets differentially affect platelet metabolism and function: a comparison with conventional platelet storage conditions. Transfusion. 2016; 56: 1807–18.
- 6Reddoch-Cardenas KM, Montgomery RK, Lafleur CB, Peltier GC, Bynum JA, Cap AP. Cold storage of platelets in platelet additive solution: an in vitro comparison of two Food and Drug Administration-approved collection and storage systems. Transfusion. 2018; 58: 1682–8.
- 7Getz TM, Montgomery RK, Bynum JA, Aden JK, Pidcoke HF, Cap AP. Storage of platelets at 4 degrees C in platelet additive solutions prevents aggregate formation and preserves platelet functional responses. Transfusion. 2016; 56: 1320–8.
- 8Reddoch KM, Pidcoke HF, Montgomery RK, Fedyk CG, Aden JK, Ramasubramanian AK, et al. Hemostatic function of apheresis platelets stored at 4 degrees C and 22 degrees C. Shock. 2014; 41(Suppl 1): 54–61.
- 9Hegde S, Wellendorf AM, Zheng Y, Cancelas JA. Antioxidant prevents clearance of hemostatically competent platelets after long-term cold storage. Transfusion. 2021; 61(2): 557–567.
- 10Yang J, Yin W, Zhang Y, Sun Y, Ma T, Gu S, et al. Evaluation of the advantages of platelet concentrates stored at 4°C versus 22°C. Transfusion. 2018; 58: 736–47.
- 11Marini I, Aurich K, Jouni R, Nowak-Harnau S, Hartwich O, Greinacher A, et al. Cold storage of platelets in additive solution: the impact of residual plasma in apheresis platelet concentrates. Haematologica. 2019; 104: 207–14.
- 12Stolla M, Fitzpatrick L, Gettinger I, Bailey SL, Pellham E, Christoffel T, et al. In vivo viability of extended 4 degrees C-stored autologous apheresis platelets. Transfusion. 2018; 58: 2407–13.
- 13Reddoch-Cardenas KM, Sharma U, Salgado CL, Montgomery RK, Cantu C, Cingoz N, et al. An in vitro pilot study of apheresis platelets collected on Trima Accel system and stored in T-PAS+ solution at refrigeration temperature (1-6 degrees C). Transfusion. 2019; 59: 1789–98.
- 14Reddoch-Cardenas KM, Peltier GC, Chance TC, Nair PM, Meledeo MA, Ramasubramanian AK, et al. Cold storage of platelets in platelet additive solution maintains mitochondrial integrity by limiting initiation of apoptosis-mediated pathways. Transfusion. 2021; 61(1): 178–190.
- 15Agey A, Reddoch-Cardenas K, Mcintosh C, Sharma U, Cantu C, Cap A, et al. Effects of intercept pathogen reduction treatment on extended cold storage of apheresis platelets. Transfusion. 2021; 61: 167–77.
- 16Bertolini F, Murphy S, Biomedical Excellence for Safer Transfusion (BEST) Working Party of the International Society of Blood Transfusion. A multicenter inspection of the swirling phenomenon in platelet concentrates prepared in routine practice. Transfusion. 1996; 36: 128–32.
- 17Johnson L, Vekariya S, Tan S, Padula MP, Marks DC. Extended storage of thawed platelets: refrigeration supports postthaw quality for 10 days. Transfusion. 2020; 60: 2969–81.
- 18Johnson L, Tan S, Jenkins E, Wood B, Marks DC. Characterization of biologic response modifiers in the supernatant of conventional, refrigerated, and cryopreserved platelets. Transfusion. 2018; 58: 927–37.
- 19Marks DC, Johnson L. Assays for phenotypic and functional characterization of cryopreserved platelets. Platelets. 2019; 30: 48–55.
- 20Blair P, Flaumenhaft R. Platelet alpha-granules: basic biology and clinical correlates. Blood Rev. 2009; 23: 177–89.
- 21Stubbs JR, Tran SA, Emery RL, Hammel SA, Haugen AL, Zielinski MD, et al. Cold platelets for trauma-associated bleeding: regulatory approval, accreditation approval, and practice implementation-just the "tip of the iceberg". Transfusion. 2017; 57: 2836–44.
- 22Warner MA, Kurian EB, Hammel SA, Van Buskirk CM, Kor DJ, Stubbs JR. Transition from room temperature to cold-stored platelets for the preservation of blood inventories during the COVID-19 pandemic. Transfusion. 2021; 61(1): 72–77.
- 23D'alessandro A, Thomas KA, Stefanoni D, Gamboni F, Shea SM, Reisz JA, et al. Metabolic phenotypes of standard and cold-stored platelets. Transfusion. 2020; 60(Suppl 3): S96–S106.
- 24Sandgren P, Shanwell A, Gulliksson H. Storage of buffy coat–derived platelets in additive solutions: in vitro effects of storage at 4°C. Transfusion. 2006; 46: 828–34.
- 25Stolla M, Bailey SL, Fang L, Fitzpatrick L, Gettinger I, Pellham E, et al. Effects of storage time prolongation on in vivo and in vitro characteristics of 4 degrees C-stored platelets. Transfusion. 2020; 60: 613–21.
- 26Paglia G, Sigurjónsson ÓE, Rolfsson Ó, Valgeirsdottir S, Hansen MB, Brynjólfsson S, et al. Comprehensive metabolomic study of platelets reveals the expression of discrete metabolic phenotypes during storage. Transfusion. 2014; 54: 2911–23.
- 27Holme S, Sweeney JD, Sawyer S, Elfath MD. The expression of p-selectin during collection, processing, and storage of platelet concentrates: relationship to loss of in vivo viability. Transfusion. 1997; 37: 12–7.
- 28Bontekoe IJ, Van Der Meer PF, Van Den Hurk K, Verhoeven AJ, De Korte D. Platelet storage performance is consistent by donor: a pilot study comparing “good” and “poor” storing platelets. Transfusion. 2017; 57: 2373–80.
- 29Solberg C, Holme S, Little C. Morphological changes associated with pH changes during storage of platelet concentrates in first-generation 3-day container. Vox Sang. 1986; 50: 71–7.
- 30Keuren JF, Magdeleyns EJ, Govers-Riemslag JW, Lindhout T, Curvers J. Effects of storage-induced platelet microparticles on the initiation and propagation phase of blood coagulation. Br J Haematol. 2006; 134: 307–13.
- 31Etulain J, Negrotto S, Carestia A, Pozner RG, Romaniuk MA, D'atri LP, et al. Acidosis downregulates platelet haemostatic functions and promotes neutrophil proinflammatory responses mediated by platelets. Thromb Haemost. 2012; 107: 99–110.
- 32Ringwald J, Zimmermann R, Eckstein R. The new generation of platelet additive solution for storage at 22°C: development and current experience. Transfus Med Rev. 2006; 20: 158–64.
- 33Van Hout FMA, Middelburg RA, Van Der Meer PF, Pors A, Wiersum-Osselton JC, Schipperus MR, et al. Effect of storage of platelet concentrates in PAS-B, PAS-C, or plasma on transfusion reactions. Transfusion. 2019; 59: 3140–5.
- 34Mathur A, Swamy N, Thapa S, Chakraborthy S, Jagannathan L. Adding to platelet safety and life: platelet additive solutions. Asian J Transfus Sci. 2018; 12: 136–40.
- 35Nogawa M, Naito Y, Chatani M, Onodera H, Shiba M, Okazaki H, et al. Parallel comparison of apheresis-collected platelet concentrates stored in four different additive solutions. Vox Sang. 2013; 105: 305–12.
- 36Van Der Meer PF, Dumont LJ, Lozano M, Bondar N, Wong J, Ismay S, et al. Aggregates in platelet concentrates. Vox Sang. 2015; 108: 96–100.
- 37Holcomb JB, Del Junco DJ, Fox EE, Wade CE, Cohen MJ, Schreiber MA, et al. The prospective, observational, multicenter, major trauma transfusion (PROMMTT) study: comparative effectiveness of a time-varying treatment with competing risks. JAMA Surg. 2013; 148: 127–36.
- 38Germain M, Grégoire Y, Vassallo RR, Acker JP, Cardigan R, De Korte D, et al. Quality control of apheresis platelets: a multicentre study to evaluate factors that can influence pH measurement. Vox Sang. 2017; 112: 318–25.
- 39Keitel S. Guide to the preparation, use and quality assurance of blood components. Strasbourg: Council of Europe Press; 2017.
- 40 AABB. Standards for blood banks and transfusion services. 29th ed. Bethesda, MD: AABB; 2014.
- 41Dumont LJ, Aubuchon JP, Gulliksson H, Slichter SJ, Elfath MD, Holme S, et al. In vitro pH effects on in vivo recovery and survival of platelets: an analysis by the BEST collaborative. Transfusion. 2006; 46: 1300–5.
- 42Goodrich RP, Li J, Pieters H, Crookes R, Roodt J, Heyns ADP. Correlation of in vitro platelet quality measurements with in vivo platelet viability in human subjects. Vox Sang. 2006; 90: 279–85.
- 43Murphy S, Gardner FH. Platelet preservation-effect of storage temperature on maintenance of platelet viability-deleterious effect of refrigerated storage. N Engl J Med. 1969; 280: 1094–8.
- 44Strandenes G, Sivertsen J, Bjerkvig CK, Fosse TK, Cap AP, Del Junco DJ, et al. A pilot trial of platelets stored cold versus at room temperature for complex cardiothoracic surgery. Anesthesiology. 2020; 133: 1173–83.
