How can we improve platelet preparation and storage?

Abstract

The use of platelet additive solutions to replace the major part of plasma as storage medium can improve storage through supply of fuel in platelet metabolism. It is important to avoid platelet activation, e.g. through optimal anticoagulation and gentle procedures at preparation. Leucodepletion of platelet concentrates (PCs) reduces HLA immunization and therapeutic refractoriness. Leucofiltration has become common to obtain leucocyte-depleted PCs, but frequently results in considerable platelet loss. Attempts at improvements must be validated, e.g. by testing post-transfusion increments and function in vivo. The in vitro bleeding-time test seems to be a valuable tool for the latter purpose. Bacterial contamination of PCs occur more commonly than so far believed, however, severe clinical complications seem to be relatively rare. Newly available methods for bacterial culture are sufficiently rapid and sensitive to be useful in PC testing. Bacterial decontamination, e.g. using psoralen-UVA, may be a future possibility for obtaining safer PCs.