Abstract
Platelet transfusion is required to treat haemo-oncology or trauma patients. Platelet apheresis (PA) performed with apheresis equipment has increased rapidly in recent years. Leucocyte-reduced platelet apheresis (LRPA) can reduce the risk of platelet refractoriness and febrile nonhemolytic transfusion reactions (FNHTRs) for transfusion. Accordingly, this study aimed to investigate and compare the platelet metabolic and functional responses between PA performed with Haemonetics and LRPA performed with Trima Accel cell separator. The qualities of platelets collected through PA and LRPA were evaluated in terms of visual appearance, morphology, platelet-aggregation changes, metabolic activities, and bacterium-screening test during 5-day storage. Statistical analyses included two-sample t-test and generalised estimating equation(GEE) method. During 5-day storage in LRPA, residual leucocytes were all <1.0×106, and the parameters of platelet function were as follows: platelet aggregated to agonists such as adenosine 5'-diphosphate (ADP) and collagen, and the extent of shape change and pO2 showed no statistically significant difference between PA and LRPA. The hypotonic shock reaction (HSR) on days 0, 1, and 3 were significantly higher in LRPA than in PA (71.78±6.92 vs. 64.10±7.42; P=0.002; 71.53±8.98 vs. 62.96±9.84; P=0.007; 68.05±7.28 vs. 57.76±6.80; P<0.0001, respectively). Values of mean platelet volume (MPV) were statistically larger in PA than in LRPA on days 0, 1, and 3. On day 5, the swirling score was higher in LRPA than in PA. The mean lactate levels had no statistically significant difference between PA and LRPA. Moreover, no growth was observed through bacterium-screening test conducted on 40 samples. Comparison of LRPA and PA products collected from the Trima Accel and Haemonetics automated blood-collection systems, respectively, revealed that both products possessed good platelet qualities even though additional processes are needed to reduce leucocytes. Furthermore, investigating the outcomes of other apheresis instruments with focus on the safety of donors, products, and recipients is necessary.
Highlights
Platelet transfusion is required to treat haemo-oncology or trauma patients
Our study showed the ability of PLTs to aggregate to adenosine 5′-diphosphate (ADP) and collagen, with no difference between Platelet apheresis (PPH) and Leucocyte-reduced platelet apheresis (LRPH) form different instruments
Our study showed that glucose levels decreased and lactate increased during the 5-day storage in PPH and LRPH products
Summary
Platelet transfusion is required to treat haemo-oncology or trauma patients. Platelets (PLTs) play a necessary role in preventing blood loss after traumatic injury and major haemorrhage. For thrombocytopenia and bleeding, transfusing PLT components (PCs) are an important treatment. To reduce donor exposure, transfusing single-donor apheresis components for patients is preferred. PLT transfusion plays a vital role in patients with hematooncological disorders. The recommended storage temperature of PCs is 20–24 °C under continuous gentle agitation. The storage time is often limited to 5 days for PCs owing to the risk of bacterial contamination [1]. Minimizing the risk of bacterial transfusion transmitted infectious diseases is an important issue. The contamination of PCs by bacteria lead to the development of a pause of PLT swirling [3]
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