title: Effects of storage duration and volume on the quality of leukoreduced apheresis-derived platelets: implications for pediatric transfusion medicine.
abstract: BACKGROUND
  Platelet (PLT) storage adversely affects PLT structure and function in vitro and is associated with decreased PLT recovery and function in vivo. In pediatric transfusion medicine, it is not uncommon for small residual volumes to remain in parent units after aliquot preparation of leukoreduced apheresis-derived PLTs (LR-ADP). However, limited data exist regarding the impact of storage on residual small-volume LR-ADP.
  
  
  METHODS
  Standard metabolic testing was performed on residual volumes of LR-ADP after aliquot removal and PLT aggregometry using a dual agonist of ADP and collagen was performed on stored, small-volume aliquots (10-80mL) created from an in vitro model of PLT storage.
  
  
  RESULTS
  Seventy-seven LR-ADP underwent metabolic (n=67) or metabolic and aggregation (n=10) studies. All products maintained a pH value of more than 6.89 throughout storage. Lactate and pCO(2) increased proportionally with longer storage time. Regardless of acceptable metabolism during storage, aggregation in 10- to 20-mL aliquots was impaired by Day 4 and aliquots less than 40 mL demonstrated the most dramatic decrease in aggregation from baseline.
  
  
  CONCLUSIONS
  Despite maintenance of acceptable metabolic conditions, residual volumes of LR-ADP develop impaired aggregation in vitro that may adversely affect PLT survival and function in vivo. At volumes below 40mL, LR-ADP revealed reduced aggregation. As a result, it is recommended to monitor and record volumes of LR-ADP used for pediatric transfusion. Moreover, once LR-ADP attain a volume of 50mL or less on Day 4 or Day 5 of storage, consider discarding these products until their in vivo efficacy can be studied.
authors.affiliation: Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Winkler
authors.forename: Chelsea A
authors.initials: CA
authors.lastname: Sheppard
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Culler
authors.forename: Robert L
authors.initials: RL
authors.lastname: Myers
authors.forename: Alexander
authors.initials: A
authors.lastname: Duncan
authors.forename: Marta-Inés
authors.initials: MI
authors.lastname: Castillejo
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Hillyer
authors.forename: Cassandra D
authors.initials: CD
authors.lastname: Josephson
mesh_terms: D001792:Blood Platelets / Q000166:cytology* / Q000378:metabolism*; D001793:Blood Preservation / Q000379:methods*; D002648:Child; D006801:Humans; D017713:Platelet Transfusion / Q000379:methods*; D010983:Plateletpheresis / Q000379:methods*; D013997:Time Factors
references.citation: Transfus Apher Sci. 2007 Jun;36(3):285-9
references.pmid: 17602871
references.citation: Transfusion. 1994 May;34(5):407-11
references.pmid: 8191565
references.citation: Transfusion. 2006 Aug;46(8):1300-5
references.pmid: 16934063
references.citation: Transfusion. 2003 Feb;43(2):143-50
references.pmid: 12559008
references.citation: Transfus Apher Sci. 2002 Feb;26(1):29-34
references.pmid: 11931375
references.citation: Transfusion. 2000 Oct;40(10):1257-63
references.pmid: 11061865
references.citation: Transfusion. 2006 May;46(5):757-65
references.pmid: 16686843
references.citation: Anesth Analg. 2005 Jan;100(1):78-81
references.pmid: 15616055
references.citation: Blood. 1982 Mar;59(3):563-8
references.pmid: 6800418
references.citation: Transfusion. 2002 Jul;42(7):847-54
references.pmid: 12375656
references.citation: Transfusion. 2004 Jun;44(6):891-9
references.pmid: 15157257
references.citation: Transfusion. 2007 Apr;47(4):653-65
references.pmid: 17381624
references.citation: Transfusion. 1991 Jun;31(5):404-8
references.pmid: 2048179
references.citation: Transfusion. 2003 Sep;43(9):1230-7
references.pmid: 12919425
references.citation: Blood. 2005 Oct 15;106(8):2723-9
references.pmid: 15972447
references.citation: Transfusion. 2005 Feb;45(2):223-7
references.pmid: 15660831
references.citation: Transfus Med. 2003 Aug;13(4):173-87
references.pmid: 12880388
references.citation: Transfus Med. 2002 Oct;12(5):317-24
references.pmid: 12383338
references.citation: Transfus Med Rev. 1997 Apr;11(2):130-44
references.pmid: 9140172