BACKGROUND: The major strategy for reducing the frequency of adverse reactions to platelet (PLT) transfusions is PLT washing with PLT additive solutions (PASs). In Japan, a mixture of medical infusion solutions such as acetate Ringer's solution, sodium bicarbonate, magnesium sulfate, and ACD-A is currently used as a PAS because none of the common types of PASs are officially permitted for clinical use. Recently, a bicarbonated Ringer's solution (BRS) was developed using bicarbonate as an alkaline agent. The aim of this study was to evaluate whether a BRS can effectively be utilized as a PAS for clinical use.
STUDY DESIGN AND METHODS: The washing and storage solution was prepared by adding 25 mL ACD-A to 500 mL of BRS (BRS-A), consisting of 95.2 mmol/L NaCl, 3.8 mmol/L KCl, 0.9 mmol/L MgCl2,1.4 mmol/L CaCl2, 26.6 mmol/L NaHCO3, 5.8 mmol/L glucose, 4.2 mmol/L trisodium citrate, and 1.8 mmol/L citric acid. The in vitro properties of apheresis PLTs suspended in BRS-A with low concentration of plasma (<5%) were compared with those suspended in 100% plasma during 7-day storage.
RESULTS: The in vitro properties of pH, hypotonic shock response, glucose consumption rate, lactate production rate, swirling, CD62P, and CD42b expression in PLTs suspended in BRS-A were comparable or superior to those suspended in 100% plasma during 7-day storage.
CONCLUSION: BRS-A, prepared by mixing the only two solutions permitted for clinical use in Japan, has a positive capability to maintain PLT function. These results indicate that PLT washing and storage with BRS-A is feasible.