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The expression of p-selectin during collection, processing, and storage of platelet concentrates: relationship to loss of in vivo viability

Authors

  • S. Holme,

    Scientific DirectorSearch for more papers by this author
    • 2

      Haemonetics Blood Services and Training Institute, Tucson, AZ

    • 1

      Stein Holme, PhD, Scientific Director, American Red Cross, Mid-Atlantic Region, Norfolk, VA

  • J.D. Sweeney,

    Medical DirectorSearch for more papers by this author
    • 4

      Blood Banks, The Miriam Hospitals, Providence, RI

    • 3

      Joseph D. Sweeney, MD, Medical Director, American Red Cross, Mid-Atlantic Region

  • S. Sawyer,

    Search for more papers by this author
    • 5

      Sherrie Sawyer, MS, Senior Research Specialist, American Red Cross, Mid-Atlantic Region

  • M.D. Elfath MD

    Chief Medical Officer, Corresponding author
      Head of Research, American Red Cross, Mid-Atlantic Region, Lewis Hall (EVMS), 700 Olney Road, Norfolk, VA 23507
    Search for more papers by this author

Head of Research, American Red Cross, Mid-Atlantic Region, Lewis Hall (EVMS), 700 Olney Road, Norfolk, VA 23507

Abstract

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.

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