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The quality of platelet concentrates related to corrected count increment: linking in vitro to in vivo
Author(s) -
Saris Anno,
Kreuger Aukje L.,
Brinke Anja,
Kerkhoffs Jean Louis H.,
Middelburg Rutger A.,
Zwaginga Jaap Jan,
Meer Pieter F.
Publication year - 2019
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.14868
Subject(s) - thromboelastography , platelet , medicine , in vitro , chemistry , biochemistry
BACKGROUND Storage of platelet concentrates (PCs) results in reduced recovery and survival of transfused platelets (PLTs). Upon storage PLTs develop storage lesion that can be monitored by several laboratory tests. However, correlation of these descriptive tests with corrected count increments (CCIs), a marker frequently used to establish the effectiveness of PLT transfusions, is limited or unknown. This study investigated to what extent a functional test or a combined in vitro rating score improves the correlation of laboratory tests with 1‐hour CCI. STUDY DESIGN AND METHODS PCs were analyzed using six different laboratory tests (n = 123) before transfusion in a prophylactic setting to 74 hematooncologic patients. Linear regression and Spearman correlation were used to determine associations between descriptive (either separately or combined in an in vitro rating score) or functional test results and 1‐hour CCIs obtained after transfusion. RESULTS CD62P expression (r = −0.45), annexin V binding (r = −0.36), the updated in vitro rating score (r = 0.50), and PLT responsiveness after thrombin receptor activator for peptide‐6 (TRAP) (r = 0.43‐0.57) or adenosine diphosphate stimulation (r = 0.11‐0.51) significantly correlated to 1‐hour CCIs obtained after transfusion, whereas lactate concentration, ThromboLUX score, and thromboelastography measurements did not. The strongest correlations were observed for in vitro rating score and PLT responsiveness after TRAP stimulation and these tests could explain 24 and 33% of the observed variation in 1‐hour CCI, respectively. CONCLUSION Combining descriptive markers in one in vitro rating score improved correlation to 1‐hour CCI compared to the tests separately. Of all tests investigated, mean PLT responsiveness after TRAP stimulation showed the strongest clinical correlation and was best able to predict the 1‐hour CCI.