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Platelet function in reconstituted whole blood variants: An observational study over 5 days of storage time

Ponschab, Martin MD; Schlimp, Christoph J. MD; Zipperle, Johannes MSc; Gabriel, Christian MD; Süssner, Susanne MSc; Cadamuro, Janne MD; Gratz, Johannes MD; Redl, Heinz PhD; Schöchl, Herbert MD

Journal of Trauma and Acute Care Surgery: November 2015 - Volume 79 - Issue 5 - p 797–804
doi: 10.1097/TA.0000000000000852
Original Articles
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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.

CONCLUSION 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.

Submitted: June 13, 2015, Revised: July 22, 2015, Accepted: July 23, 2015.

Address for reprints: Herbert Schöchl, MD, AUVA Trauma Centre Salzburg, Austria and Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Centre, Donaueschingenstrasse 13, 1200 Vienna, Austria; email: herbert.schoechl@auva.at.

© 2015 Lippincott Williams & Wilkins, Inc.