BACKGROUND: Recent studies suggested that platelet activation with surface expression of p‐selectin on stored platelets may be related to a loss of viability. At present, there has been no thorough investigation of the extent or significance of p‐selectin expression during the collection, processing, and storage of platelet concentrates (PCs) under various conditions. STUDY DESIGN AND METHODS: Platelet surface expression of p‐selectin (CD62) was determined on fixed platelet samples using fluorescein‐conjugated monoclonal antibodies. Platelet viability was assessed by autologous transfusion of platelets stored for 5 days and labeled with either 51Cr or 111in. RESULTS: Little (2–10%) platelet expression of p‐selectin was found in whole blood and platelet‐rich‐plasma preparations, whereas PCs showed a substantial increase in p‐selectin expression to levels of 20 to 30 percent. Both fresh PCs and those stored for 5 days, obtained with one cell separator (MCS, Haemonetics) showed substantially lower levels of p‐selectin expression than PCs from two other cell separators (Spectra, COBE, and CS‐3000 with TNX‐6, Baxter Healthcare). Exposure of platelets to EDTA, cold, or a pH below 6.2, conditions that are known to result in the loss of viability upon transfusion, produced substantial and irreversible p‐selectin expression. PCs with a pH of 6.2 to 6.8 (conditions in which no loss of viability has been demonstrated) also showed pronounced p‐selectin expression, which returned to control values after incubation at 37° C in plasma at pH 7.0 to 7.2. With storage under current conditions the in vivo studies (n = 61) demonstrated a rather poor correlation between p‐selectin expression and the percentage of recovery (r = −0.25) but a somewhat better correlation with survival (r = −0.42). Better correlations were observed with the extent of shape change, lactate, and hypotonic shock response. CONCLUSION: These studies show that p‐selectin expression on the platelet surface is a predictor of platelet viability, although the extent of shape change and the hypotonic shock response may be more sensitive.
Transfusion – Wiley
Published: Jan 1, 1997
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