title: A randomized controlled trial comparing autologous radiolabeled in vivo platelet (PLT) recoveries and survivals of 7-day-stored PLT-rich plasma and buffy coat PLTs from the same subjects.
abstract: BACKGROUND
  A recent review concluded that there was inadequate evidence to show a difference between buffy coat (BC) and platelet (PLT)-rich plasma (PRP) PLT concentrates prepared from whole blood. We hypothesized that 7-day-stored BC-PLTs would have superior autologous recoveries and survivals compared to PRP-PLTs and that both would meet the Food and Drug Administration (FDA) criteria for poststorage viability.
  
  
  METHODS
  This was a randomized, crossover study design in healthy subjects who provided informed consent. Each participant donated a unit of whole blood on two occasions. In random order, either BC-PLTs or PC-PLTs were prepared after a 20 ± 2 °C overnight hold of the whole blood. PLTs were stored under standard conditions. On Day 7, fresh PLTs were prepared from 43 mL of autologous whole blood. The fresh PLTs paired with either BC-PLTs or PRP-PLTs were alternately labeled with (111) In or (51) Cr and simultaneously reinfused to determine recoveries and survivals. In vitro assays were performed on Days 1 and 7.
  
  
  RESULTS
  Fourteen subjects completed the study at two sites. No differences in poststorage PLT viabilities were observed between BC-PLTs and PRP-PLTs; recovery differences averaged 3.7 ± 2.4% (± SE, p = 0.15) and survival differences averaged 0.48 ± 0.56 days (p = 0.41). Neither type of PLTs met the current FDA criteria for either poststorage PLT recoveries or survivals.
  
  
  CONCLUSIONS
  We were unable to demonstrate that single-unit BC-PLTs stored for 7 days have superior poststorage viability compared to PRP-PLTs. Failure to meet the minimum FDA criteria for poststorage PLT viability raises questions regarding the acceptance thresholds of these metrics.
authors.affiliation: Department of Pathology, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA. larry.j.dumont@hitchcock.org
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Dumont
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Dumont
authors.forename: Zoe M
authors.initials: ZM
authors.lastname: Unger
authors.forename: Alan
authors.initials: A
authors.lastname: Siegel
authors.forename: Zbigniew M
authors.initials: ZM
authors.lastname: Szczepiorkowski
authors.forename: Jill S
authors.initials: JS
authors.lastname: Corson
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Jones
authors.forename: Todd
authors.initials: T
authors.lastname: Christoffel
authors.forename: Esther
authors.initials: E
authors.lastname: Pellham
authors.forename: S Lawrence
authors.initials: SL
authors.lastname: Bailey
authors.forename: Sherrill J
authors.initials: SJ
authors.lastname: Slichter
mesh_terms: D001792:Blood Platelets / Q000166:cytology*; D001793:Blood Preservation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D053657:Platelet-Rich Plasma / Q000166:cytology*