New strategies to understand platelet storage lesion

Abstract

Modern health care is dependent on the banking and transfusion of platelet concentrates. Platelets, however, can pose a problem for stock management at blood banks due to their limited storage time. In most countries, platelets can be stored from 3 to 7 days and due limited storage time up to 30% of all platelet concentrates are discarded without ever being used for clinical transfusion. The main reasons for this limited storage time are increased risk of bacterial contamination, due to the storage conditions at 22°C, and a formation of a condition termed platelet storage lesion (PSL) that decreases the quality of the platelets and makes them less efficient for clinical use as the storage prolongs. Increased understanding of PSL formation and how it can be combated is important to increase the quality of platelets during storage, in turn making them more efficient for clinical use. There are several methods used to detect formation of PSL, including analysing expression of surface markers on platelets using flow cytometry, analysing function of platelets using light transmission aggregometry and release of cytokines and growth factors using, for example ELISA. However, those methods focus more on studying the consequence of PSL instead of the cause of PSL. In recent years, several laboratories, including ours, have been using novel ways to further try to understand the formation of PSL. These include, for example analysing changes in proteomics, miRNA and metabolomics in platelets during storage. In this short overview, we will review how novel methods have been used to shed new lights on the formation of PSL.