Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 35  |  Issue : 3  |  Page : 984-990

Do apheresis platelet concentrates with additive solution offer advantages in vitro or in therapeutic utility?


1 Department of Clinical Pathology, Faculty of Medicine, National Liver Institute, Menoufia University, Menoufia, Egypt
2 Department of Clinical Pathology, National Liver Institute, Menoufia University, Menoufia, Egypt

Date of Submission30-Nov-2021
Date of Decision28-Dec-2021
Date of Acceptance05-Jan-2022
Date of Web Publication29-Oct-2022

Correspondence Address:
Amira Z Badawy
Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Menoufia 32511
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_279_21

Rights and Permissions
  Abstract 


Objective
To investigate the in vitro quality of room temperature stored apheresis platelet concentrates (PCs) with and without adding a platelet additive solution (PAS) and to evaluate its therapeutic utility in oncology patients.
Background
Several studies have highlighted using PAS as a way to improve the storage conditions of PCs. PAS is a synthetic media used in the place of plasma for platelet (PLT) storage. It is used to support metabolism, provide buffering capacity, and to protect PLTs from the storage lesion. So, it can be used to extend shelf life of PCs. To date, its application in Egyptian blood banks has not been increased.
Patients and methods
Twenty apheresis PCs were collected and stored at room temperature and divided into two groups; A1 group suspended in 100% plasma and tested on days 0 and 5 and A2 group suspended in 65% SSP + PAS and tested on days 0, 5, 7, and 10 of storage for PLT count, mean platelet volume, pH, partial pressure of oxygen, partial pressure of carbon dioxide, bicarbonate level, swirling, bacterial examination, glucose, lactate, lactate dehydrogenase, annexin expression, and PLT aggregation. SSP + PCs were transfused to oncology patients against plasma PCs and the corrected count increment (CCI) was calculated.
Results
SSP + PCs were comparable to plasma PCs up to day 7 of storage regarding all studied parameters when compared with day 5 of group A1; 7 days SSP + PCs showed a CCI comparable to plasma PCs.
Conclusion
We reported a maintained PLT function and metabolism up to 7 days of storage of apheresis PCs in 65% SSP + with a CCI comparable to plasma PCs.

Keywords: annexins, blood banks, corrected count increment, plateletpheresis, transfusion


How to cite this article:
EL-Edel RH, El-Tounsi IA, Badawy AZ, Bedair HM, El-Zaiat RS. Do apheresis platelet concentrates with additive solution offer advantages in vitro or in therapeutic utility?. Menoufia Med J 2022;35:984-90

How to cite this URL:
EL-Edel RH, El-Tounsi IA, Badawy AZ, Bedair HM, El-Zaiat RS. Do apheresis platelet concentrates with additive solution offer advantages in vitro or in therapeutic utility?. Menoufia Med J [serial online] 2022 [cited 2024 Mar 28];35:984-90. Available from: http://www.mmj.eg.net/text.asp?2022/35/3/984/359480




  Introduction Top


Platelets (PLTs) are critical for the conservation of hemostasis and have an essential role in preventing blood loss after traumatic injury[1]. Apheresis PLT is a broadly used component for various thrombocytopenic patients[2]. The benefits of transfusion are evident by the improved clinical outcomes in thrombocytopenic patients[3].

Nowadays, PLT products are stored at 22°C with 200–300 ml of donor plasma with gentle agitation to optimize survival and recovery, but shelf life is limited to 5 days due to the hazards of bacterial contamination[4].

Despite the millions of PLT products transfused annually, most of the stock is wasted[5]. Trials to increase the shelf life of platelet concentrates (PCs) gave rise to platelet additive solutions (PASs)[6].

PASs are nutrient media, which were first developed in the 1980s and continued to be upgraded over the following years[2]. Various generations of PASs (including PAS I, PAS II, PAS III) were formulated to counteract the PLT storage lesion. Citrate, acetate, potassium, magnesium, phosphate, bicarbonate (HCO3), calcium, and glucose were tested in an effort to maintain the PLT quality during storage[7].

Apart from PAS supporting metabolism during storage, it also offers the advantage of collecting further plasma from each donation that can be utilized for transfusions or fractionation. It potentially minimizes plasma-related immune reactions and may support in pathogen inactivation systems[6].

Oncology patients are continuously in need for PC transfusion either prophylactic or therapeutic after intensive radiotherapy or chemotherapy[8].

To date, PAS application in Egyptian blood banks has not been increased. The present study aimed to investigate the in vitro quality of SSP + PCs and evaluate their therapeutic utility in thrombocytopenic oncology patients.


  Patients and methods Top


This study was conducted at Blood Bank Unit, Clinical Pathology Department; Menoufia University Hospital, Menoufia, Egypt during the period from December 2019 to December 2020. The study protocol was approved by the Ethics Research Committee of Menoufia University and informed consent from each participant was taken.

PLT collection and storage: 20 U of apheresis PLTs were donated according to National Standards for Blood Donation using an apheresis collection system (Trima Accel, Terumo BCT, Lakewood, Colorado, USA) and stored at room temperature (20–24°C) in a countertop agitator (PC1200h, Helmer Scientific, Indiana, USA) and were divided into two groups; A1 group in which PCs were suspended in 100% plasma and stored for 5 days and were tested on days 0 and 5 of storage and A2 group in which PCs were collected as a hyperconcentrated product (4000 × 103/μl) than usual (1400 × 103/μl), after modifying the configuration in the apparatus[9]. They were diluted to a final ratio of 65% PAS/35% plasma through the addition of PAS (SSP+; MacoPharma, Mouveaux, France) [Table 1] directly to the PLT bag after collection using a sterile connecting device. They were tested on days 0, 5, 7, and 10 of storage.
Table 1: Composition of SSP+additive solution

Click here to view


Sampling: bags were mixed and stripped and then 10 ml samples were collected into plain tubes aseptically on specified days of storage.

PLT concentration and mean platelet volume (MPV) were assessed using a hematology analyzer (CELL-DYN Ruby; Abbott Laboratories, Wiesbaden, Germany). PLT yield was obtained by multiplying PC volume and PLT concentration.

Partial pressure of oxygen (pO2), partial pressure of carbon dioxide (pCO2), HCO3, and potential of hydrogen (pH) were measured immediately after sampling using a blood gas analyzer (Medica's EasyStat; Medica Corporation, Bedford, Massachusetts, USA).

PLT aggregation function and swirling: PLT aggregation function was investigated by light transmission aggregometry using a Lumi-aggregometer (Apact 4004; LabiTec, Ahrensburg, Germany) as mentioned before[9]. The following agonists were tested: ADP (5 μ mol/l) and collagen (5 μmol/l). Tests were run for 6 min and aggregation percent (%) was reported.

Swirling was checked visually by inspecting bags opposite to light. Swirling was graded from 0 to +4[10].

Glucose, lactate, and lactate dehydrogenase (LDH): PLT supernatants were prepared by double centrifugation of the samples[11]. Glucose and lactate were analyzed by a Chemistry Autoanalyzer (AU680; Beckman Coulter, Fullerton, California, USA). Lactate was analyzed spectrophotometrically using a Lactate-Liquizyme kit supplied by Spectrum, Egypt.

Annexin expression: apheresis PLTs were stained with Annexin V monoclonal antibody (Invitrogen; Thermo Fisher Scientific, Vienna, Austria) as a marker of apoptosis. Flow cytometry was performed using a flow cytometer (CytoFLEX; Beckman Coulter) with a special forward scatter photomultiplier tube capable of detecting particles not more than 1 μm in size. The Auto Controls were analyzed first to adjust the gating on the PLT population and to ascertain the minimum fluorescence above which positive cells were identified. PLTs were identified by their forward scatter and side scatter properties as described by Vučetić et al.[12].

Sterility testing: an automated blood culture system (BD BACTEC FX40; Becton Dickinson) was used for bacterial testing of all PCs on day 5 in group A1 and day 7 in group A2, which is the day of transfusion to patients. We transferred 4–10 ml of PC to culture vials (BD BACTEC Peds Plus/F; Becton Dickinson) and incubated at 37°C for 7 days[13].

Determination of therapeutic response to PCs using corrected count increment (CCI): SSP + PCs were transfused on day 7 to hematology oncology patients of ages ranged from 14 to 64 years against plasma PCs. Patients having immune thrombocytopenic purpura, thrombogenic thrombocytopenic purpura, and disseminated intravascular coagulopathy were not included in the study. Using a hematology analyzer (CELL-DYN Ruby; Abbott Laboratories) determination of PLT concentration before and after transfusion by1 and 24 h was done. Body surface area was determined by Mosteller formula[14]. CCI was calculated by the equation CCI = (posttransfusion–pretransfusion PLT count × 103/l)×body surface area (m2)/number of PLTs transfused × 1011[15]. The transfusion reached the target if the CCI result at 1 h was more than 7500 and at 24 h were more than 4500.

Statistical analysis

SPSS software (IBM SPSS statistics, version 20.0; IBM Corp., Armonk, New York, USA) was used as a statistical software for data analysis. The Kolmogorov–Smirnov test was used to verify the normality of distribution. Quantitative data were described using range and mean. Significance of the results was judged at the 5% level. The applied tests were Student's t test and paired t test. We compared the corresponding days in both groups and compared days of group A2 with day 5 of group A1 which is the current standard of PLT storage.


  Results Top


Our study included 20 healthy donors; their median age was 35 years, they were all males, and their median PLT count was 254 × 103/ml.

In this study, PLT content of all PCs ranged between 240 × 109 and 310 × 109 PLTs/unit on the day of collection. The mean pH of SSP + units on all days until day 10 ranged between 6.67 and 7.53.

The results indicate that there was a slow decline in PLT count through storage in A1 and A2 groups. In SSP+ PCs, it declines from 1341.3 ± 34.56 × 109/l on day 0 to 1128.5 ± 38.72 × 109/l on day 10. But it is still comparable to day 5 of group A1 (mean 1389.50 ± 46.24) and up to day 7 (mean 1270.60 ± 35.38, P = 0.056) while on day 10 (mean 1128.50 ± 38.72, P < 0.001), the PLT count was significantly decreased than day 5 of group A1 [Figure 1]a.
Figure 1: (a) Descriptive analysis of the studied cases according to PLT count (×103/ml) in both groups; A1 (PCs in 100% plasma) and A2 (PCs in 65% PAS). (b) Descriptive analysis of the studied cases according to glucose level (mg/dl) in both groups; A1 (PCs in 100% plasma) and A2 (PCs in 65%PAS). (c) Descriptive analysis of the studied cases according to annexin expression (%) in both groups; A1 (PCs in 100% plasma) and A2 (PCs in 65% PAS). PAS, platelet additive solution; PC, platelet concentrates; PLT, platelet.

Click here to view


PLT aggregation in response to agonists (ADP and collagen) and swirling were maintained in SSP+ PCs up to day 10. Detection of bacterial contamination using the BacT/ALERT system showed no evidence of bacterial contamination in the all units tested of both groups over storage.

On the day of collection, SSP+ units displayed significantly lower levels of glucose (P < 0.001), lactate (P < 0.001), LDH (P < 0.001), pCO2 (P < 0.001), and HCO3 (P < 0.001) than plasma units, which contained 100% plasma. The glucose level was depleted completely at day 10 in group A2 [Figure 1]b. So, it was difficult to ascertain the clinical meaning of differences in these variables. So, we preferred to assess glucose consumption, lactate production, and LDH production rates from baseline levels in all PCs.

On comparing corresponding days 0 in two groups, our results showed no statistically significant difference regarding PLT count, MPV, pH, pO2, and annexin expression while pCO2 (P < 0.001) and HCO3 (P < 0.001) were significantly lower in group A2 than A1. Also, there was significant difference regarding collagen (P = 0.001) and ADP (P = 0.048), aggregation functions being higher in group A2 than A1 [Table 2].
Table 2: Comparison between corresponding days (days 0 and 5) in the two studied groups (A1 and A2) according to all studied parameters

Click here to view


Also comparing corresponding days 5 in both groups revealed that there were no statistically significant difference regarding PLT count, MPV, pH, pO2, pCO2, HCO3, and LDH production rate while glucose consumption rate (P = 0.009), lactate production rate (P = 0.034), and annexin expression (P < 0.001) were significantly lower in group A2 than A1. Furthermore, collagen (P = 0.048) and ADP (P = 0.016) aggregation functions were significantly higher in group A2 than in A1 [Table 2].

Our data revealed no statistically significant difference regarding all studied parameters on day 7 when compared with day 5 of group A2 except for annexin expression (P < 0.001), which was significantly lower in day 7 than day 5 of group A1 [Table 3].
Table 3: Comparison between day 5 of group A1 (100% plasma) with days 7 and 10 in group A2 (65% platelet additive solution) according to all studied parameters

Click here to view


While on comparing day 10 with day 5 of group A1, our data showed significantly lower PLT count (P < 0.001) and HCO3 level (P = 0.025) on day 10 than day 5 of group A1 (100% plasma). Also, glucose consumption rate (P = 0.01) and lactate production rate (P = 0.014) were significantly lower on day 10 than day 5 while the LDH production rate (P < 0.001) was significantly higher on day 10 than day 5 [Table 3].

The results comparing 1 and 24 h CCI showed no statistically significant difference in both 1 h CCI (mean 23.96 ± 2.05, P = 0.066) and 24 h CCI (mean 9.92 ± 0.97, P = 0.168) between both groups of patients transfused with SSP+ PCs and plasma PCs [Table 4].
Table 4: Comparison between patients transfused with room temperature stored platelet concentrates (100% plasma) and patients transfused with room temperature stored platelet concentrates (70% additive) on day 7 according to corrected count increment

Click here to view



  Discussion Top


PASs have been introduced to extend the shelf life of PCs while maintaining PLT quality. Several synthetic solutions, as SSP+, are utilized to improve PLT quality and studies continue for optimizing PLT quality by upgrading the ingredients of additive solutions[16].

In this study, the mean PLT content in the tested units ranged from 243 × 109 to 251 × 109 PLTs/unit; these levels met the UK guidelines[17], which states that 75% of PCs tested should contain a total of more than ir equal to 240 × 109 PLTs/unit.

The PLT concentration was gradually decreasing in two groups. PLT count on day 7 in group A2 was not statistically different from that of day 5 in group A1, which is the current standard for PC storage emphasizing that the PLT count was maintained comparable despite storage extension of up to day 7 in group A2. Mokhtar et al.[18] found that PLT concentration was more in PAS PLTs despite the difference being not statistically significant. However, Hornsey et al.[11] stated that there was reduced PLT count in SSP+ PCs. These differences could be due to the variation of PLT concentration, volume of the bag, and bag quality.

In this study, swirling of PLTs was preserved in all PCs of both groups up to day 10 with no significant difference. Jain et al.[19] found that swirling was greatest on days 0 and 4 of storage in both groups. Bashir et al.[20] stated that swirling in PAS PCs was more than in plasma PCs up to day 10. Observation of the swirling phenomenon represents monitoring of the shape of functioning PLTs. So conserved swirling in our results co-occurring with preserved MPV and PLT aggregation function indicates that no significant PLTs shape change or functional changes occurred during storage.

MPV often increases during PLT storage due to shape change from disk to sphere. In this study, MPV was not significantly different between the two groups. Jain et al.[19] observed increasing of MPV in two groupings on day 4. Also, Bashir et al.[20] revealed that MPV is increased in PCs of two groups, but MPV in PAS PCs was significantly more sustained than plasma PCs. Thus, SSP+ might have a role in preventing transformation of PLTs from disk to sphere thus preventing PLT activation.

The mean pH in group A2 (SSP+ PCs) on all days until day 10 ranged from 6.67 to 7.53, which is well over the FDA acceptance criterion for a pH value of 6.2[9]. However, there was stepwise decline in pH in A1 and A2 groups and this came in agreement with Gupta et al.[21], who revealed that pH declined but sustained within tolerable range on day 7 at room temperature, while Mokhtar et al.[18] observed a gradational decrement in pH value for both groups being significantly inferior in SSP+ PCs. pH preservation may be related to acetate present in SSP+, which provides an alternative source of energy rather than glycolysis and lactate production.

There was a gradual decrease in the HCO3 level through storage in two groups with no significant difference. HCO3 that acts as the main buffer in plasma is consumed by taking up H ions produced by glycolysis. The pCO2 values gradually lessened while the pO2 values rose slowly with no statistically significant difference. A coequal result was gained by Hornsey et al.[11], who observed restricted metabolism with lessened consumption of O2 and declined release of CO2.

Glucose consumption and lactate production rates were significantly lower in group A2. The same result was observed by Sandgren et al.[22], who observed that the glucose level reduced to 0 on day 5 in InterSol PCs, which led to declined lactate production. Also Johnson et al.[2] stated that PAS PCs showed decrement in glucose consumption and lactate production. Glucose is a significant marker of viable PLTs. Decreased glucose consumption and lactate production are simply explained as SSP+ contains acetate that could be utilized instead of glucose in PLT metabolism.

In our study, LDH production rate levels were not statistically significant between corresponding days of the studied groups. Similar results were obtained by Gupta et al.[21], who stated that LDH remained constant in two groups. However, Sandgren et al.[22] observed that LDH increased in the plasma PCs greater than PAS PCs. On day 10 of SSP+ PCs (group A2), LDH production rate was significantly higher than day 5 in group A1, which is reflected by significant decrease in PLT count as LDH is an indicator of cell destruction.

Our study showed maintained PLT aggregation functions in response to ADP and collagen agonists till day 10 of storage in group A2 compared by day 5 in group A1. Similar results were obtained by Plaza et al.[23], who stated that the aggregation response of buffy coat PLTs to four strong agonists including collagen remained at 75% of baseline levels after 7 days. While a study by Hirayama et al.[24] revealed that the collagen-induced aggregation in the plasma, Seto-sol, and PASIIIM preparations was preserved above 50% on day 7, but decreased below 30% on day 14 while the aggregation in the M-sol was preserved above 70% on days 7 and 14. Baurand et al.[25] stated that PAS units showed deterioration of PLT responsiveness to weak agonists as ADP. The difference in these results may be related to the different types of PASs and agonists used.

Annexin V binding was utilized as index of apoptosis as it binds to phosphatidylserine translocated to the PLT surface. In our study, annexin expression was significantly lower in SSP+ PCs than in plasma PCs up to day 10 [Figure 1]c. This is opposite to the study by Saunders et al.[26], which observed that further phosphatidylserine was translocated on the surface of PLTs in SSP + units, while Bashir et al.[27] observed that the percentage of PLT-binding annexin V was not significant between plasma PCs and PAS PCs.

When transfusing extended stored PCs in SSP+ on day 7 against traditional PCs, we observed that 1 and 24 h CCI in patients transfused with SSP+ PLTs were comparable to those of plasma PCs. Drawz et al.[28] compared many PAS stored PCs and observed that SSP+ PCs had better CCI than PCs stored in Intersol.

Although PLTs pH, aggregation function, and apoptotic marker on day 10 were comparable to day 5 of group A1, the PLT count significantly decreased and glucose was completely depleted as SSP+ does not contain glucose. So, we did not transfuse PCs on day 10 and further studies are recommended to investigate the extending storage up to day 10 in vivo and in vitro by adding glucose to PAS.


  Conclusion Top


Our study showed that extending shelf life of apheresis PCs can be done up to 7 days if we use SSP+ as an additive solution. Besides, these units can be transfused safely to patients at this time with adequate PLT survival as PLT count, function, and metabolism were maintained with no risk of bacterial contamination.

Acknowledgements

Financial support and sponsorship: Faculty of Medicine, Menoufia University.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Hess AS, Ramamoorthy J, Hess JR. Perioperative platelet transfusions. Anesthesiology 2021; 134:471–479.  Back to cited text no. 1
    
2.
Johnson L, Winter KM, Hartkopf-Theis T, Reid S, Kwok M, Marks DC. Evaluation of the automated collection and extended storage of apheresis platelets in additive solution. Transfusion 2012; 52:503–509.  Back to cited text no. 2
    
3.
Getz TM, Montgomery RK, Bynum JA, Aden JK, Pidcoke HF, Cap AP. Storage of platelets at 4°C in platelet additive solutions prevents aggregate formation and preserves platelet functional responses. Transfusion 2016; 56:1320–1328.  Back to cited text no. 3
    
4.
Jimenez-Marco T, Castrillo A, Hierro-Riu F, Vicente V, Rivera J. Frozen and cold-stored platelets: reconsidered platelet products. Platelets 2021; 28:1–8.  Back to cited text no. 4
    
5.
Elmi M, Sirigireddy B, Abukar J, Tchipeva D, Chauhan N, Tsitsikas DA. 'Low platelet usage' haematology laboratories: to store or not to store? PLoS One 2017; 12:e0187340.  Back to cited text no. 5
    
6.
Alhumaidan H, Sweeney J. Current status of additive solutions for platelets. J Clin Apher 2012; 27:93–98.  Back to cited text no. 6
    
7.
Van der Meer PF. PAS or plasma for storage of platelets? A concise review. Transfus Med 2016; 26:339–342.  Back to cited text no. 7
    
8.
De Wildt-Eggen J, Nauta S, Schrijver JG, van Marwijk Kooy M, Bins M, van Prooijen HC. Reactions and platelet increments after transfusion of platelet concentrates in plasma or an additive solution: a prospective, randomized study. Transfusion 2000; 40:398–403.  Back to cited text no. 8
    
9.
Reddoch-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°C). Transfusion 2019; 59:1789–1798.  Back to cited text no. 9
    
10.
Singh RP, Marwaha N, Malhotra P, Dash S. Quality assessment of platelet concentrates prepared by platelet rich plasma-platelet concentrate, buffy coat poor-platelet concentrate (BC-PC) and apheresis-PC methods. Asian J Transfus Sci 2009; 3:86.  Back to cited text no. 10
    
11.
Hornsey VS, McColl K, Drummond O, McMillan L, Morrison A, Morrison L, et al. Extended storage of platelets in SSP+platelet additive solution. Vox Sang 2006; 91:41–46.  Back to cited text no. 11
    
12.
Vučetić D, Ilić V, Vojvodić D, Subota V, Todorović M, Balint B. Flow cytometry analysis of platelet populations: usefulness for monitoringthe storage lesion in pooled buffy-coat platelet concentrates. Blood Transfus 2018; 16:83.  Back to cited text no. 12
    
13.
Basu D, Basu S, Radhakrishnan VS, Bhattacharya S, Chakraborty S, Sinha S, Chandy M. Comparison of quality and efficacy of apheresis platelets stored in platelet additive solution vis a vis plasma. Indian J Hematol Blood Transf 2021; 37:648–657.  Back to cited text no. 13
    
14.
Mosteller RD. Simplified calculation of body-surface area. N Engl J Med 1987; 317:1098.  Back to cited text no. 14
    
15.
Nester T, AuBuchon JP. Hemotherapy decisions and their outcomes. Technical Manual 17th AABB. United States: American Association of Blood Bank; 2011.  Back to cited text no. 15
    
16.
Devine DV, Serrano K. The platelet storage lesion. Clin Lab Med 2010; 30:475–487.  Back to cited text no. 16
    
17.
Murphy S, Rebulla P, Bertolini F, Holme S, Moroff G, Snyder E, et al. In vitro assessment of the quality of stored platelet concentrates. The Biomedical Excellence for Safer Transfusion (BEST) Task Force of the International Society of Blood Transfusion. Transfusion Medicine Review 1994; 8: 29–36.  Back to cited text no. 17
    
18.
Mokhtar MB, Hashim HB, Joshi SR. Assessment of quality of platelets preserved in plasma and platelet additive solution: a Malaysian experience. Asian J Transfus Sci 2016; 10:84.  Back to cited text no. 18
    
19.
Jain P, Tendulkar A, Gupta A. First Indian initiative for preparation of low-titer group 'O' single-donor platelets with platelet additive solution. Asian J Transfus Sci 2018; 12:10.  Back to cited text no. 19
    
20.
Bashir S, Mohsin S, Amin H, Rehman M, Hussain S, Saeed T. Comparison of changes in platelet count, mean platelet volume and swirling in stored platelet concentrates with and without platelet additive solution. J Appl Hematol 2014; 5:10.  Back to cited text no. 20
    
21.
Gupta A, Chandra T, Kumar A. In vitro function of random donor platelets stored for 7 days in composol platelet additive solution. Asian J Transfus Sci 2011; 5:160.  Back to cited text no. 21
    
22.
Sandgren P, Mayaudon V, Payrat JM, Sjödin A, Gulliksson H. Storage of buffy-coat-derived platelets in additive solutions: in vitro effects on platelets stored in reformulated PAS supplied by a 20% plasma carry-over. Vox Sang 2010; 98 (3p2):415–422.  Back to cited text no. 22
    
23.
Plaza EM, Lozano ML, Guiu IS, Egea JM, Vicente V, De Terán LC, Rivera J. Evaluation of platelet function during extended storage in additive solution, prepared in a new container that allows manual buffy-coat platelet pooling and leucoreduction in the same system. Blood Transfus 2012; 10:480.  Back to cited text no. 23
    
24.
Hirayama J, Azuma H, Fujihara M, Homma C, Yamamoto S, Ikeda H. Storage of platelets in a novel additive solution (M-sol), which is prepared by mixing solutions approved for clinical use that are not especially for platelet storage. Transfusion 2007; 47:960–965.  Back to cited text no. 24
    
25.
Baurand A, Eckly A, Bari N, Léon C, Hechler B, Cazenave JP, Gachet C. Desensitization of the platelet aggregation response to ADP: differential down-regulation of the P2Y1 and P2cyc receptors. Thromb Haemost 2000; 84:484–491.  Back to cited text no. 25
    
26.
Saunders C, Rowe G, Wilkins K, Holme S, Collins P. In vitro storage characteristics of platelet concentrates suspended in 70% SSP+(TM) additive solution versus plasma over a 14-day storage period. Vox Sang 2011; 101:112–121.  Back to cited text no. 26
    
27.
Bashir S, Kemsley K, Min K, Swann ID, Cardigan R. Platelet storage in more than 90% additive solution containing glucose and bicarbonate has the potential to increase shelf life. Transfusion 2018; 58:2959–2968.  Back to cited text no. 27
    
28.
Drawz SM, Marschner S, Yanez M, Garcia de Coca A, Feys HB, Deeren D, Coene J. Observational study of corrected count increments after transfusion of platelets treated with riboflavin pathogen reduction technology in additive solutions. Transfusion 2015; 55:1745–1751.  Back to cited text no. 28
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Patients and methods
Results
Discussion
Conclusion
References
Article Figures
Article Tables

 Article Access Statistics
    Viewed658    
    Printed38    
    Emailed0    
    PDF Downloaded75    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]