In:
Transfusion, Wiley, Vol. 62, No. 11 ( 2022-11), p. 2304-2313
Kurzfassung:
Transfusion of cold‐stored platelet concentrates (CS‐PCs) appears effective in massively bleeding patients. However, few studies have evaluated their in vivo hemostatic function in severe thrombocytopenia. Study Design and Methods The in vivo function of plasma‐depleted human PCs was evaluated in rabbits with a blocked reticuloendothelial system and busulfan‐induced thrombocytopenia. On day 1, a human apheresis PC was processed in a platelet additive solution (PAS‐PC) and split evenly for cold or room temperature storage (RTS). On days 3, 6, or 9, RTS‐ or CS‐PAS‐PCs were transfused (4.0 × 10 9 platelets/kg) after plasma depletion into two to four rabbits that developed adequate thrombocytopenia ( 〈 25 × 10 9 /L). Ear bleeding time was measured by two incisions in small veins. The hemostatic rate was defined as the percentage of rabbits achieving bleeding cessation within 600 s at either incision. The experiment was repeated using five different PCs on each storage day. Results The mean pre‐transfusion rabbit platelet count was 8.6 ± 5.2 × 10 9 /L. The hemostatic rates with RTS‐ and CS‐PAS‐PCs were both 100% on day 3, 93 ± 15% and 73 ± 15% on day 6 ( p = .07), and 65 ± 36% and 73 ± 37% on day 9 ( p = .27), respectively, with no statistical differences. Total platelet counts were significantly lower after CS‐PAS‐PC than RTS‐PAS‐PC transfusion on all days (e.g., 58.7 ± 5.7 vs. 42.4 ± 14.7 × 10 9 /L, p = .0007, day 9), and did not reach 50 × 10 9 /L in several experiments. Platelet count increments correlated significantly with hemostatic efficacy for CS‐PAS‐PC transfusion only. Discussion CS‐PAS‐PCs might achieve similar hemostasis as RTS‐PAS‐PCs in thrombocytopenic patients with mild bleeding. Hemostatic efficacy could be improved by transfusing more CS‐PAS‐PCs.
Materialart:
Online-Ressource
ISSN:
0041-1132
,
1537-2995
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2022
ZDB Id:
2018415-3
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