Novel and unexpected clearance mechanisms for cold platelets.
Storage at room temperature is limited to 5 days because of the risk of bacterial growth and loss of platelet functionality. Platelet refrigeration remains impossible, because once chilled, platelets are rapidly removed from circulation. Chilling platelets (<4h) clusters glycoprotein (GP) Ibalpha receptors, and beta(2) integrins on hepatic macrophages recognize clustered beta GlcNAc residues leading to rapid clearance of acutely chilled platelets. Prolonged refrigeration increases the exposure of galactose residues such that, unexpectedly, hepatocytes remove platelets using their asialoglycoprotein receptors. Here we review current knowledge of the mechanisms of platelet removal, the existing knowledge of refrigerated platelet function, and methods to preserve platelet concentrates long-term for transfusion.
Rumjantseva
Viktoria
V
Division of Translational Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Hoffmeister
Karin M
KM
D000818:Animals; D037263:Asialoglycoprotein Receptor / Q000378:metabolism; D001792:Blood Platelets / Q000166:cytology* / Q000502:physiology; D001793:Blood Preservation / Q000379:methods*; D048430:Cell Shape; D002470:Cell Survival; D003080:Cold Temperature; D005690:Galactose / Q000378:metabolism; D022781:Hepatocytes / Q000502:physiology*; D006801:Humans; D037102:Lectins / Q000502:physiology; D051379:Mice; D010587:Phagocytosis / Q000502:physiology*; D015539:Platelet Activation; D010976:Platelet Count; D010980:Platelet Membrane Glycoproteins / Q000378:metabolism; D017713:Platelet Transfusion; D012034:Refrigeration; D013997:Time Factors
D037263:Asialoglycoprotein Receptor; D037102:Lectins; D010980:Platelet Membrane Glycoproteins; D005690:Galactose