Leukocyte depletion and storage of single-donor platelet concentrates. 1997

V Weisbach, and A Putzo, and J Zingsem, and M Riewald, and R Zimmermann, and R Eckstein, and H Riess
Department of Transfusion Medicine and Hemostascology, Friedrich Alexander University Erlangen-Nürnberg, Germany.

OBJECTIVE Because of widespread use of leukocyte reduction in platelet concentrates (PCs) and the need to store such concentrates, we investigated the effects of leukocyte depletion on the quality of stored PCs. METHODS Ten double-sized PCs were divided into 2 equal units which were tested simultaneously. One half was stored for 5 days after filtration through a polyester filter, the other one was stored unfiltered. RESULTS The volume of the 10 "oversized' PCs was 483 +/- 40 ml (mean +/- standard deviation) and they contained 5.9 +/- 1.5 x 10(11) platelets and 80 +/- 23 x 10(6) leukocytes. Filtration significantly reduced the leukocyte concentration (168 +/- 56/microliter before, 6 +/- 4 /microliter after filtration) and leukocyte count (39.9 +/- 11.3 x 10(6) vs. 1.3 +/- 0.9 x 10(6); p < 0.0005). Filtration caused a platelet loss of 16%, the platelet count decreasing not significantly from 2.91 +/- 0.75 x 10(11) to 2.40 +/- 0.94 x 10(11) (p = 0.26). After 5 days of storage all parameters of platelet function (platelet aggregation to several stimuli, hypotonic shock reaction [HSR] and platelet retraction), mean platelet volume, and pH and pCO2 showed no advantage for PCs filtered prior to storage compared to PCs stored unfiltered. Moreover, platelet aggregation on day 5 using 4 agonists at 10 concentrations showed worse results in 4 assays in prestorage filtered PCs (collagen [4 micrograms/ml: p < 0.05, ADP [0.2 mM]: p < 0.05, ADP [0.3 mM]: p < 0.05, thrombin [0.6 E/ml]: p < 0.05). But there is no convincing trend in all aggregation tests, and HSR, presumably the most useful parameter, was not different or day 5. CONCLUSIONS There is no advantage in terms of improved quality for prestorage leuko-depletion of PCs. Taking into account the obvious disadvantages of filtration, such as platelet loss and increasing costs per transfusion, we conclude that pre- or post-storage filtration of single-donor PCs should be done only for patients who have a clear indication for the transfusion of leukocyte-poor blood products.

UI MeSH Term Description Entries
D007937 Leukapheresis The preparation of leukocyte concentrates with the return of red cells and leukocyte-poor plasma to the donor. Leukocytapheresis,Leukopheresis,Lymphapheresis,Lymphocytapheresis,Leukocytopheresis,Lymphocytopheresis,Lymphopheresis,Leukaphereses,Leukocytaphereses,Leukocytophereses,Leukophereses,Lymphaphereses,Lymphocytaphereses,Lymphocytophereses,Lymphophereses
D001782 Blood Donors Individuals supplying blood or blood components for transfer to histocompatible recipients. Blood Donor,Donor, Blood,Donors, Blood
D001792 Blood Platelets Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. Platelets,Thrombocytes,Blood Platelet,Platelet,Platelet, Blood,Platelets, Blood,Thrombocyte
D001793 Blood Preservation The process by which blood or its components are kept viable outside of the organism from which they are derived (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). Blood Preservations,Preservation, Blood,Preservations, Blood
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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