Original article

Vol. 22 No. 5 (2024): Blood Transfusion 5-2024 (September-October)

The effects of pathogen reduction technology on apheresis platelet concentrates stored in PAS

Authors

Key words: Apheresis platelets, TEG, ROTEM, pathogen inactivation technology, platelet storage efficacy

Abstract

Background - The impact of pathogen reduction technology (PRT) such as Mirasol, and the effect of platelet additive solutions (PAS) on the activity and hemostatic profile of transfused apheresis platelets remain largely unknown. Aim of this study was to assess the in vitro hemostatic and metabolic profile of Mirasol treated platelets in PAS during a 7-day storage period.

Material and methods - Ten split bags containing apheresis platelets stored in PAS were split into two groups; control platelets (10 units) and PRT-treated platelets (10 units). In vitro evaluation of the platelet components was performed on the 1st, 3rd, 5th, and 7th days of the storage period. Several metabolic parameters including pH, glucose, and lactate levels were evaluated, while assessment of their hemostatic capacity was performed using light transmission aggregometry (LTA) and viscoelastic studies such as rotational thromboelastometry (ROTEM) and thromboelastography (TEG). Last, Annexin V levels were measured though flow cytometry for evaluation of platelet activation.

Results - Clot strength, as reflected by the maximum clot firmness (MCF) and the maximum amplitude (MA) parameters of the viscoelastic studies was significantly decreased in the PRT-treated platelets compared to the control platelets (p<0.05). Clot strength based on MCF and MA values was also found to be decreasing over storage time in PRT-treated platelets (p<0.001), while this was not evident in control platelets. Moreover, the comparison between pH, glucose, and lactate levels were indicative of increased metabolic activity in PRT-treated platelets compared to control platelets (p<0.001). Annexin-V was significantly higher in PRT-treated platelets compared to control platelets on the 7th day of the storage period (p<0.001).

Discussion - The results of this study indicate that increased PSL induced by PRT treatment leads to a decreased in vitro platelet hemostatic efficacy and increased metabolic activity. However, the clinical impact of these alternations needs further investigation.

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Authors

Stavros Tsalas - Laboratory of Hematology and Blood Bank Unit, “Attikon” Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Andreas G. Tsantes - Laboratory of Hematology and Blood Bank Unit, “Attikon” Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Eleni Petrou - Laboratory of Hematology and Blood Bank Unit, “Attikon” Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Sofia Mellou - Transfusion Department, General Hospital of Athens "G. Gennimatas", Athens, Greece

Rozeta Sokou - Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, Nikea, Piraeus, Greece

Electra Loukopoulou - Laboratory of Hematology and Blood Bank Unit, “Attikon” Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Anastasios G. Kriebardis - Laboratory of Reliability and Quality Control in Laboratory Hematology, Department of Biomedical Science, School of Health and Caring Science, University of West Attica, Athens, Greece

Sotirios P. Fortis - Laboratory of Reliability and Quality Control in Laboratory Hematology, Department of Biomedical Science, School of Health and Caring Science, University of West Attica, Athens, Greece

Dimitrios V. Papadopoulos - 2nd Academic Department of Orthopaedics, School of Medicine, National & Kapodistrian University of Athens, Athens, Greecee

Aristeidis G. Vaiopoulos - Laboratory of Hematology and Blood Bank Unit, “Attikon” Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Styliani Kokoris - Laboratory of Hematology and Blood Bank Unit, “Attikon” Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Argirios E. Tsantes - Laboratory of Hematology and Blood Bank Unit, “Attikon” Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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