Value of calcium and phosphate in a bicarbonate‐containing platelet additive solution with low plasma levels in maintaining key in vitro platelet storage parameters. Issue 2 (17th November 2016)

• Record Type: Journal Article
• Authors: Skripchenko, Andrey; Turgeon, Annette; Thompson‐Montgomery, Dedeene; Awatefe, Helen; Wagner, Stephen J.
• Is Part Of: Transfusion. Volume 57:Issue 2(2017)
• Page Start: 349
• Page End: 356
• Publication Date: 2016-11-17
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.13894
• Languages: English
• ISSNs: 0041-1132

Abstract

Abstract : BACKGROUND: Use of recently developed platelet (PLT) additive solutions (PAS) with 5% plasma levels may reduce the frequency and/or severity of transfusion reactions attributed to plasma. PLTs suspended in bicarbonate‐containing PAS‐5 with 5% plasma levels can maintain key PLT parameters during 7‐day storage. This study evaluates the role of calcium and phosphate, as constituents of PAS‐5, in maintaining PLT parameters. STUDY DESIGN AND METHODS: An Amicus apheresis PLT unit (n = 13) was equally divided into four 60‐mL aliquots in CF‐250 polyolefin bags. Four different formulations of PAS‐5 were prepared: PAS‐5, PAS‐5 without phosphate (−PO4 ), PAS‐5 without calcium (−Ca), and PAS‐5 without Ca and phosphate (−Ca/−PO4 ). PLTs were centrifuged, and the supernatant was expressed and replaced with the respective PAS, yielding PLTs suspended in 95% PAS and 5% plasma. PLTs were stored at 20 to 24ºC with agitation for 7 days. PLT in vitro parameters were evaluated on Days 1, 5, and 7. RESULTS: In PLT PAS‐5 aliquots, pH levels were maintained better compared with those in −Ca and –Ca/−PO4 aliquots. Glycolysis was greater in −Ca and –Ca/−PO4 PLT aliquots compared with PAS‐5 aliquots. Hypotonic stress response and morphology were less and p‐selectin (CD62P) binding was greater in –Ca/−PO4 PLT aliquots. The accumulation of reactive oxygen species was greater in –Ca/−PO4 PLTs. Phosphorylation of p38 mitogen‐activated protein kinase (MAPK) was greater in –Ca and −Ca/−PO4 PLT aliquots during storage. CONCLUSION: The removal of calcium and phosphate from PAS‐5 leads to the activation of p38 MAPK and deterioration of key PLT storage parameters.