title: Removal of biological response modifiers associated with platelet transfusion reactions by columns containing adsorption beads.
abstract: BACKGROUND
  Biological response modifiers (BRMs), such as soluble CD40 ligand (sCD40L); regulated upon activation, normal T-cell expressed, and secreted (RANTES); and transforming growth factor-β1 (TGF-β1), are released from platelets (PLTs) during storage and may trigger adverse effects after PLT transfusion. Although washing PLTs is effective at reducing the level of BRMs and the incidence of transfusion reactions, the washing procedure is time-consuming and may induce PLT activation. Furthermore, some BRMs continue to accumulate during the storage of washed PLTs. A method to remove BRMs using adsorbent columns has not yet been developed.
  
  
  METHODS
  We evaluated the ability of columns packed with Selesorb and Liposorber beads, which are both clinically used, to remove BRMs from PLT concentrates (PCs) stored for 5 days. The levels of these BRMs were determined before and after adsorption.
  
  
  RESULTS
  The adsorption columns significantly reduced the levels of RANTES and sCD40L and partially reduced TGF-β1. There were no significant effects on PLT activation, aggregation, morphology, and plasma lactate dehydrogenase (an indicator of PLT lysis) levels, or hypotonic shock response. Adsorption, however, reduced the PLT recovery to approximately 60% of the untreated value.
  
  
  CONCLUSIONS
  This study showed that the levels of BRMs were substantially reduced using columns of clinically available adsorption beads. PLT functions and the quality of PCs were maintained after adsorption. The use of adsorption columns may be useful in reducing the incidence of nonhemolytic transfusion reactions.
authors.affiliation: Japanese Red Cross Kinki Block Blood Center, Osaka, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Tanaka
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hayashi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Tani
authors.forename: Fumiya
authors.initials: F
authors.lastname: Hirayama
mesh_terms: D000327:Adsorption; D001781:Blood Component Removal; D001787:Blood Group Incompatibility / Q000276:immunology / Q000517:prevention & control*; D001792:Blood Platelets / Q000166:cytology* / Q000276:immunology; D058731:Blood Safety / Q000379:methods; D019013:CD40 Antigens / Q000032:analysis / Q000302:isolation & purification; D002469:Cell Separation / Q000379:methods; D018946:Chemokine CCL5 / Q000032:analysis / Q000302:isolation & purification; D006801:Humans; D007155:Immunologic Factors / Q000302:isolation & purification*; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008863:Microspheres; D015539:Platelet Activation; D017713:Platelet Transfusion / Q000009:adverse effects*; D053773:Transforming Growth Factor beta1 / Q000032:analysis / Q000302:isolation & purification
chemical_list: D019013:CD40 Antigens; D018946:Chemokine CCL5; D007155:Immunologic Factors; D053773:Transforming Growth Factor beta1; D007770:L-Lactate Dehydrogenase