The effects of pathogen reduction technology on apheresis platelet concentrates stored in PAS

Stavros Tsalas; Andreas G Tsantes; Eleni Petrou; Sofia Mellou; Rozeta Sokou; Electra Loukopoulou; Anastasios G Kriebardis; Sotirios P Fortis; Dimitrios V Papadopoulos; Aristeidis G Vaiopoulos; Styliani Kokoris; Argirios E Tsantes

doi:10.2450/BloodTransfus.600

The effects of pathogen reduction technology on apheresis platelet concentrates stored in PAS

Blood Transfus. 2024 Jan 9. doi: 10.2450/BloodTransfus.600. Online ahead of print.

Affiliations

¹ Laboratory of Hematology and Blood Bank Unit, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
² Transfusion Department, General Hospital of Athens "G. Gennimatas", Athens, Greece.
³ Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, Nikea, Piraeus, Greece.
⁴ Laboratory of Reliability and Quality Control in Laboratory Hematology, Department of Biomedical Science, School of Health and Caring Science, University of West Attica, Athens, Greece.
⁵ 2nd Academic Department of Orthopaedics, School of Medicine, National & Kapodistrian University of Athens, Athens, Greecee.

PMID: 38315533
DOI: 10.2450/BloodTransfus.600

Abstract

Background: The impact of pathogen reduction technology (PRT) such as Mirasol, and the effect of platelet additive solutions (PAS) on the activity and hemostatic profile of transfused apheresis platelets remain largely unknown. The aim of this study was to assess the in vitro hemostatic and metabolic profile of Mirasol treated platelets in PAS during a 7-day storage period.

Material and methods: Ten split bags containing apheresis platelets stored in PAS were split into two groups; control platelets (No.=10 units) and PRT-treated platelets (No.=10 units). In vitro evaluation of the platelet components was performed on the 1^st, 3^rd, 5^th, and 7^th days of the storage period. Several metabolic parameters including pH, glucose, and lactate levels were evaluated, while assessment of their hemostatic capacity was performed using light transmission aggregometry (LTA) and viscoelastic studies such as rotational thromboelastometry (ROTEM) and thromboelastography (TEG). Last, Annexin V levels were measured though flow cytometry for evaluation of platelet activation.

Results: Clot strength, as reflected by the maximum clot firmness (MCF) and the maximum amplitude (MA) parameters of the viscoelastic studies was significantly decreased in the PRT-treated platelets compared to the control platelets (p<0.05). Clot strength based on MCF and MA values was also found to be decreasing over storage time in PRT-treated platelets (p<0.001), while this was not evident in control platelets. Moreover, the comparison between pH, glucose, and lactate levels were indicative of increased metabolic activity in PRT-treated platelets compared to control platelets (p<0.001). Last, Annexin-V was significantly higher in PRT-treated platelets compared to control platelets on the 7^th day of the storage period (p<0.001).

Discussion: The results of this study indicate that increased PSL induced by PRT treatment leads to a decreased in vitro platelet hemostatic efficacy and increased metabolic activity. However, the clinical impact of these alternations needs further investigation.