Platelet storage lesion: an update on the impact of various leukoreduction processes on the biological response modifiers.
Currently, platelet concentrates are produced either from pooled buffy which are leukoreduced during processing, by various types of WBC removal filters and several apheresis technologies, which are leukocyte-reduced during collection with or without filtration. It is therefore important to define the impact of various leukocyte-removal processes on the acceleration of platelet storage of lesion and cellular apoptosis/necrosis. This overview briefly highlights the effects of exposure to artificial surfaces, during apheresis leukoreduction processes and platelet storage bags on the development of the platelet storage lesion that may contribute to transfusion reactions. The results obtained from three plateletpheresis technologies are compared with data from a "like with like" study on buffy-coat-derived platelet concentrates, using three types of platelet filter/pack assemblies. Emphasis is placed on the combined preparative methods and storage bags on generation/removal of: kallikrein/kinin; activated complement, leukocytes and platelet-derived cytokines and the development of cellular injuries, measured by the release of Annexin V. There was no systematic evidence of significant cellular fragmentation caused by filtration, but the combined preparative methods and storage bags appears to have some impact on the rate of release of soluble HLA. Moreover, large variability was observed between and within groups, in terms of various laboratory markers of biocompatibility and major biological response modifiers, indicating that much still remains to be done on various aspects of quality improvement to fully abrogate platelet concentrates associated transfusion reactions.
Seghatchian
Jerard
J
Blood Component Technology and Thrombosis/Haemostasis Consultancy, 50 Primrose Hill Road, London NW3 3AA, UK. jseghatchian@btopenworld.com
D017304:Annexin A5 / Q000737:chemistry; D017209:Apoptosis; D001672:Biocompatible Materials; D001781:Blood Component Removal / Q000379:methods; D001792:Blood Platelets / Q000166:cytology*; D001793:Blood Preservation; D001803:Blood Transfusion; D018946:Chemokine CCL5 / Q000378:metabolism; D018925:Chemokines / Q000378:metabolism; D015926:Complement C3a / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D003593:Cytoplasm / Q000378:metabolism; D005374:Filtration; D006801:Humans; D007155:Immunologic Factors / Q000378:metabolism*; D016209:Interleukin-8 / Q000378:metabolism; D007937:Leukapheresis / Q000379:methods*; D007958:Leukocyte Count; D007962:Leukocytes / Q000166:cytology* / Q000378:metabolism; D009336:Necrosis; D017713:Platelet Transfusion; D010983:Plateletpheresis / Q000379:methods; D016212:Transforming Growth Factor beta / Q000378:metabolism
D017304:Annexin A5; D001672:Biocompatible Materials; D018946:Chemokine CCL5; D018925:Chemokines; D016207:Cytokines; D007155:Immunologic Factors; D016209:Interleukin-8; D016212:Transforming Growth Factor beta; D015926:Complement C3a