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Platelet concentrates promote procoagulant activity: evidence from experimental studies using a perfusion technique
Author(s) -
Hernandez M.R.,
Bozzo J.,
Mazzara R.,
Ordinas A.,
Escolar G.
Publication year - 1995
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1995.35895357897.x
Subject(s) - platelet , fibrin , perfusion , chemistry , whole blood , medicine , immunology
BACKGROUND : Evaluation of the hemostatic effectiveness of platelet transfusions is difficult. Perfusion methods have been employed to test the quality and function of platelet concentrates, allowing differentiation between platelet‐platelet and platelet‐surface interactions. STUDY DESIGN AND METHODS : A study was performed to investigate platelet adhesive and cohesive properties as well as the formation of fibrin when aliquots of platelet concentrates were added to thrombocytopenic blood. Blood previously anticoagulated with low‐ molecular‐weight heparin (20 U/mL) underwent platelet and white cell reduction by filtration. Perfusates were prepared by adding to filtered blood platelets obtained from standard concentrates (stored for 1, 3, and 5 days). The final platelet count in these perfusates was standardized at 80,000 per microL. After perfusions, platelet‐ subendothelium interaction and fibrin formation were analyzed morphometrically. Results were always compared with those obtained in unfiltered blood (> 150,000 platelets/microL). RESULTS : A slight impairment in the ability of stored platelets to interact with the subendothelium was noticed during the storage period. However, the presence of fibrin was significantly greater than that observed in studies with unfiltered blood (Day 1 = 23.48 +/− 9.43%*; Day 3 = 26.99 +/− 6.74%*; Day 5 = 17.95 +/− 9.06% vs. unfiltered blood = 12.60 +/− 3.08%; *p < 0.05). The lower platelet counts (80,000/microL) in the perfusates containing platelets from concentrates could account for the reduced platelet‐subendothelium interactions, but they cannot explain the increments in fibrin formation. CONCLUSION : While the preparation and storage of platelets have a detrimental effect on platelet adhesiveness, such procedures can positively influence the platelet procoagulant activity necessary to platelet hemostasis.