Platelet concentrates from buffy coats: improved conditions for preparation and evaluation in routine clinical use.
Since 1990, platelet concentrates prepared by soft centrifugation of buffy-coat pools diluted with a glucose-free, commercially available crystalloid solution (BC-PC) are the first choice product for all platelet recipients in our institution.  Numerous in vitro and in vivo observations from our own and other laboratories indicate that BC-PC compare favorably to PC prepared from platelet-rich plasma (PRP).  In the present in vitro study we evaluated traditional and bottom-and-top bags and modified centrifugation conditions with the aim of increasing in vitro platelet yield in BC-PC. This was 14-18% higher compared with our previous protocol when prolonged centrifugation and bottom-and-top bags were used.  In addition, we evaluated post-transfusion platelet count increments in 42 unselected adult hematological patients routinely transfused with 703 1-5 day-old BC-PC pools.  Transfusion data were managed with PLATELET, an MS-DOS compatible program which includes automated calculation of transfusion efficacy and periodic patient reports. Mean pre-, 1 h and 24 h post-transfusion platelet counts were 16, 38 and 28x10 9/L, respectively.  Mean 1 h and 24 h post-transfusion platelet count increments, expressed as percentage of expected, were 40 and 24%, respectively.  These data were similar to those obtained previously in 189 unselected hematological patients given 2432 PRP-PC transfusions (mean 1 h post-transfusion increment 46% of expected).  The present in vitro study confirms that similar platelet yields can be obtained with the BC and PRP methods.  In vivo findings show that also in routine conditions post-transfusion increments of PRP-PC and BC-PC are similar.(ABSTRACT TRUNCATED AT 250 WORDS)
Centro Trasfusionale e di Immunologia dei Trapianti, Ospedale Maggiore, Milano, Italy.
P
P
Rebulla
F
F
Bertolini
L
L
Porretti
F
F
Marangoni
C
C
Smacchia
M
M
Marconi
D
D
Riccardi
V
V
Sirelson
M
M
Pappalettera
G
G
Sirchia
D000328:Adult; D001781:Blood Component Removal / Q000379:methods*; D016913:Blood Component Transfusion / Q000379:methods*; D001792:Blood Platelets; D005069:Evaluation Studies as Topic; D006801:Humans; D010976:Platelet Count / Q000379:methods; D012984:Software