Temperature cycling during platelet cold storage improves in vivo recovery and survival in healthy volunteers

Transfusion. 2018 Jan;58(1):25-33. doi: 10.1111/trf.14392. Epub 2017 Nov 8.

Abstract

Background: Room temperature (RT) storage of platelets (PLTs) can support bacterial proliferation in contaminated units, which can lead to transfusion-transmitted septic reactions. Cold temperature storage of PLTs could reduce bacterial proliferation but cold exposure produces activation-like changes in PLTs and leads to their rapid clearance from circulation. Cold-induced changes are reversible by warming and periodic rewarming during cold storage (temperature cycling [TC]) has been proposed to alleviate cold-induced reduction in PLT circulation.

Study design and methods: A clinical trial in healthy human volunteers was designed to compare in vivo recovery, survival, and area under the curve (AUC) of radiolabeled autologous apheresis PLTs stored for 7 days at RT or under TC or cold conditions. Paired comparisons of RT versus TC and TC versus cold PLTs were conducted.

Results: Room temperature PLTs had in vivo recovery of 55.7 ± 13.9%, survival of 161.3 ± 28.8 hours, and AUC of 5031.2 ± 1643.3. TC PLTs had recovery of 42.6 ± 16.4%, survival of 48.1 ± 14.4% hours, and AUC of 1331.3 ± 910.2 (n = 12, p < 0.05). In a separate paired comparison, cold PLTs had recovery of 23.1 ± 8.8%, survival of 33.7 ± 14.7 hours, and AUC of 540.2 ± 229.6 while TC PLTs had recovery of 36.5 ± 12.9%, survival of 49.0 ± 17.3 hours, and AUC of 1164.3 ± 622.2 (n = 4, AUC had p < 0.05).

Conclusion: TC storage for 7 days produced PLTs with better in vivo circulation kinetics than cold storage but is not equivalent to RT storage.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenosine Diphosphate / pharmacology
  • Annexin A5 / metabolism
  • Area Under Curve
  • Blood Platelets / cytology*
  • Blood Platelets / drug effects
  • Blood Preservation / methods*
  • Blood Transfusion, Autologous
  • Cell Shape
  • Cell Survival
  • Collagen / pharmacology
  • Cryopreservation / methods*
  • Healthy Volunteers
  • Humans
  • Hydrogen-Ion Concentration
  • Organ Preservation Solutions / chemistry
  • P-Selectin / blood
  • Platelet Activation / drug effects
  • Platelet Glycoprotein GPIb-IX Complex / analysis
  • Platelet Transfusion*
  • Temperature*
  • Time Factors

Substances

  • Annexin A5
  • Organ Preservation Solutions
  • P-Selectin
  • Platelet Glycoprotein GPIb-IX Complex
  • Adenosine Diphosphate
  • Collagen