Abstract
Washed and/or replaced platelet concentrates (W/R-PCs) are used to prevent the adverse effects of platelet transfusion. W/R-PCs are prepared mostly by one of two methods, but no comparison of these methods has been reported. In this study, platelet function and transfusion effects were compared between a PC prepared by washing apheresis-derived platelets (plasma-PC) with the washing-replacement-preservation solution M-sol and resuspending them with the same solution (WR-method), and that prepared by centrifuging plasma-PC and replacing the plasma with M-sol (R-method).
The two methods were compared in vitro with respect to platelet recovery, concentration of residual plasma protein and functional parameters (pH, aggregation, %HSR, CD62P, %disk). They were also compared in vivo for transfusion effects, i.e. corrected count increment (CCI) and prophylactic effects on adverse reactions.
Percent recovery of WR-PC and R-PC were 90.5±1.4% (n=7) and 89.5±1.8% (n=7), respectively (p=0.209), and percent removal of plasma protein was 96.9±0.7% (n=7) and 95.4±0.9% (n=7), resulting in a residual plasma protein per bag of 428±95mg (n=7) and 627±130mg (n=7), respectively (p<0.01). Except for pH, no difference in parameter values in vitro was found between the two methods during 48 hours storage (5 days after donation). While the pH of plasma-PCs declined to 7.05±0.04 after 24 hours storage, that of WR-PC and R-PC remained at 7.37±0.03 and 7.40±0.02, respectively, after this time, although a transient pH reduction was observed immediately after preparation in both methods. For patients who suffered severe anaphylactic shock by plasma-PC transfusion, 75 bags of WR-PC (for 6 patients) and 31 bags of R-PC (for 4 patients) were transfused. Post-transfusion 24-hour CCI was 1.53±0.82 (n=51) in WR-PC and 1.59±0.78 (n=18) in R-PC. Prophylactic effects were observed in both PCs. No adverse reaction was observed with either WR-PC or R-PC.
R-PC was comparable to WR-PC in all regards. Thus, the R-method, which is more feasible in practice, is preferable as a plasma-reduction method.
