Platelet function in reconstituted whole blood variants: An observational study over 5 days of storage time.
BACKGROUND
Platelet concentrates (PCs) are usually stored at room temperature under constant gentle agitation. Risk of bacterial contamination limits maximum storage time to 5 days. The objective of the study was to investigate platelet function with regard to storage time in different reconstituted whole blood (RWB) variants.


METHODS
Donated apheresis PCs were stored at 22°C over 5 days. To obtain RWB, apheresis PCs were mixed with plasma-free packed red blood cells (RBCs) and either prethawed fresh frozen plasma (PT) or solvent-detergent plasma (SD) [1:1:1 ratio], or with leukocyte- and platelet-depleted whole blood (LD-WB) as control. Platelet function in RWB variants was assessed by impedance aggregometry (Multiplate) on Days 0, 1, 3, and 5 following platelet donation.


RESULTS
Platelet aggregometry did not reach the lower limits determined from healthy volunteers in any of the RWB variants. Platelet aggregability measured by ASPI test, ADP test, and COL test declined over storage time in all RWB variants. No differences were observed in the TRAP test. At most measurement time points, LD-RWB provided significantly higher platelet aggregability compared with SD-RWB and PT-RWB (p < 0.01). SD-RWB demonstrated higher platelet aggregability on Day 0 in the ASPI test, ADP test, and TRAP test compared with PT-RWB.


CONCLUSIONS
Apheresis PCs stored for 5 days at 22°C demonstrated reduced platelet aggregability, as measured by multiple electrode aggregometry when mixed with RBCs and plasma. As platelet aggregation in LD-RWB was superior compared with SD-RWB and PT-RWB variants, it might be possible that additives in RBCs or plasma are responsible for the observed depressed platelet function. Critical evaluation of current massive transfusion recommendations proposing early platelet transfusion is indicated.
From the Ludwig Boltzmann Institute for Experimental and Clinical Traumatology (M.P., C.J.S., J.Z., H.R., H.S.), AUVA Research Centre; and Department of Anaesthesia, General Intensive Care and Pain Control (J.G.), Medical University of Vienna, Vienna; Red Cross Blood Transfusion Service for Upper Austria (C.G., S.S.), Linz; Department of Laboratory Medicine (J.C.), Paracelsus Medical University Salzburg; and Department of Anaesthesiology and Intensive Care (H.S.), AUVA Trauma Centre, Salzburg, Austria.
Martin
M
Ponschab
Christoph J
CJ
Schlimp
Johannes
J
Zipperle
Christian
C
Gabriel
Susanne
S
Süssner
Janne
J
Cadamuro
Johannes
J
Gratz
Heinz
H
Redl
Herbert
H
Schöchl
D000704:Analysis of Variance; D001771:Blood Banks; D001792:Blood Platelets / Q000502:physiology*; D001793:Blood Preservation / Q000379:methods*; D058731:Blood Safety; D005260:Female; D006801:Humans; D008297:Male; D010974:Platelet Aggregation / Q000502:physiology*; D010979:Platelet Function Tests; D017713:Platelet Transfusion; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013916:Thrombelastography / Q000379:methods; D013997:Time Factors; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000175:diagnosis / Q000628:therapy