Pieter F. van der Meer

Storage of platelets in additive solution for up to 12 days with maintenance of good in-vitro quality.

BACKGROUND:u2002 Storage of PLT concentrates (PCs) may be extended beyond 5 days, provided in‐vitro and in‐vivo variables allow longer storage and bacterial screening is performed. The aim of this study was to examine in‐vitro storage characteristics of PCs in various storage solutions: plasma only, or mixtures of plasma with PAS‐II, PAS‐III, PAS‐IIIM, and Composol.

Development of blood transfusion product pathogen reduction treatments: A review of methods, current applications and demands

Transfusion-transmitted infections (TTI) have been greatly reduced in numbers due to the strict donor selection and screening procedures, i.e. the availability of technologies to test donors for endemic infections, and routine vigilance of regulatory authorities in every step of the blood supply chain (collection, processing and storage). However, safety improvement is still a matter of concern because infection zero-risk in transfusion medicine is non-existent. Alternatives are required to assure the safety of the transfusion product and to provide a substitution to systematic blood screening tests, especially in less-developed countries or at the war-field. Furthermore, the increasing mobility of the population due to traveling poses a new challenge in the endemic screening tests routinely used, because non-endemic pathogens might emerge in a specific population. Pathogen reduction treatments sum a plethora of active approaches to eliminate or reduce potential threatening pathogen load from blood transfusion products. Despite the success of pathogen reduction treatments applied to plasma products, there is still a long way to develop and deploy pathogen reduction treatments to cellular transfusion products (such as platelets, RBCs or even to whole blood) and there is divergence on its acceptance worldwide. While the use of pathogen reduction treatments in platelets is performed routinely in a fair number of European blood banks, most of these treatments are not (or just) licensed in the USA or elsewhere in the world. The development of pathogen reduction treatments for RBC and whole blood is still in its infancy and under clinical trials. In this review, we discuss the available and emerging pathogen reduction treatments and their advantages and disadvantages. Furthermore, we highlight the importance of characterizing standard transfusion products with current and emerging approaches (OMICS) and clinical outcome, and integrating this information on a database, thinking on the benefits it might bring in the future toward personalized transfusion therapies.

Influence of pH on stored human platelets.

BACKGROUND: During storage at room temperature, platelets (PLTs) undergo several changes, a process known as PLT storage lesion. The pH is one of the variables changing and has been suggested to be a good surrogate marker for the quality of PLT concentrates. It is unknown whether the pH decrease as such induces the PLT storage lesion or that the deterioration of the PLTs results in the pH decrease. In this study, the responses of PLTs to applied pH values were investigated.

Overnight storage of whole blood: a comparison of two designs of butane‐1,4‐diol cooling plates

BACKGROUND: Whole blood (WB) can be stored overnight before processing, provided that it is quickly cooled to room temperature (20‐25°C), for example, with butane‐1,4‐diol plates. A new design of cooling plates became available (CompoCool‐WB, Fresenius HemoCare), where WB must be placed vertically against the plates, versus placing of WB under plates in the current version (Compocool). This study compared cooling efficiency and in vitro quality of plasma and of stored white cell (WBC)‐reduced red cells (RBCs) from overnight‐stored WB, cooled with either of the systems.

Six filters for the removal of white cells from red cell concentrates, evaluated at 4°C and/or at room temperature

BACKGROUND: Six filters were tested for their ability to remove white cells from buffy coat‐depleted red cell concentrates at various temperatures.

Platelet preservation: Agitation and containers

For platelets to maintain their in vitro quality and in vivo effectiveness, they need to be stored at room temperature with gentle agitation in gas-permeable containers. The mode of agitation affects the quality of the platelets, and a gentle method of agitation, either a circular or a flat bed movement, provides the best results. Tumblers or elliptical agitators induce platelet activation and subsequent damage. As long as the platelets remain in suspension, the agitation speed is not important. Agitation of the platelet concentrates ensures that the platelets are continuously oxygenated, that sufficient oxygen can enter the storage container and that excess carbon dioxide can be expelled. During transportation of platelet concentrates, nowadays over long distances where they are held without controlled agitation, platelets may tolerate a certain period without agitation. However, evidence is accumulating that during the time without agitation, local hypoxia surrounding the platelets may induce irreversible harm to the platelets. Over the decades, more gas-permeable plastics have been used to manufacture platelet containers. The use of different plastics and their influence on the platelet quality both in vitro and in vivo is discussed. The improved gas-permeability has allowed the extension of platelet storage from 3 days in the early 1980s, to currently at least 7 days. In the light of new developments, particularly the introduction of pathogen reduction techniques, the use of platelet additive solutions and the availability of improved automated separators, further (renewed) research in this area is warranted.

Pathogen reduction treatment using riboflavin and ultraviolet light impairs platelet reactivity toward specific agonists in vitro.

Recent studies showed that Mirasol pathogen reduction treatment (PRT) leads to increased P‐selectin expression and increased oxygen and glucose consumption in resting platelets (PLTs). This study investigates the effect of PRT on PLT activation.

Riboflavin and UV light treatment of platelets: a protective effect of platelet additive solution?

Pathogen reduction technologies (PRTs) increase the safety of the blood supply, but are also associated with cell damage. Our aim was to investigate the effect of Mirasol PRT on platelet (PLT) concentrates stored in plasma and whether the use of a PLT additive solution (PAS) is able to improve in vitro quality.

The effect of interruption of agitation on in vitro measures of platelet concentrates in additive solution

BACKGROUND: Interruption of agitation results in lower in vitro quality of platelet concentrates (PCs). The rates at which the deleterious effects occur, however, are unknown. Therefore, in vitro parameters of PCs in additive solution (AS) during various periods without agitation have been investigated.

Platelet concentrates, from whole blood or collected by apheresis?

Platelet concentrates can be isolated from donated whole blood with the platelet-rich plasma-method or the buffy coat-method. Alternatively, platelets can be obtained by apheresis, harvesting the platelets but returning all other cells to the donor. The quality and characteristics of platelets during storage are affected by a number of factors, such as anticoagulant, centrifugation and processing after collection, and pre- or post storage pooling, but when comparing literature on the various methods, most differences balance out. To have sufficient platelets to treat an adult patient, whole-blood-derived platelet concentrates need pooling of multiple donations, thereby increasing the risk of infectious agent transmission at least two-fold as compared with apheresis units. Allo immunization rates, acute reaction rates, and transfusion related acute lung injury rates are not different. Apheresis donation procedures have fewer adverse events. All these factors need to be considered and weighed when selecting a method of platelet collection for a blood center.