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Flow cytometric assessment of agonist-induced P-selectin expression as a measure of platelet quality in stored platelet concentrates

Authors

  • Rutger A. Middelburg,

    Corresponding author
    1. Jon J. van Rood Center for Clinical Transfusion Research, Leiden University Medical Center, Leiden, the Netherlands
    2. Department of Clinical Chemistry and Haematology, UMCU, Utrecht, the Netherlands
    • Center for Clinical Transfusion Research, Sanquin Research
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  • Mark Roest,

    1. Center for Clinical Transfusion Research, Sanquin Research
    2. Jon J. van Rood Center for Clinical Transfusion Research, Leiden University Medical Center, Leiden, the Netherlands
    3. Department of Clinical Chemistry and Haematology, UMCU, Utrecht, the Netherlands
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  • Jannemieke Ham,

    1. Center for Clinical Transfusion Research, Sanquin Research
    2. Jon J. van Rood Center for Clinical Transfusion Research, Leiden University Medical Center, Leiden, the Netherlands
    3. Department of Clinical Chemistry and Haematology, UMCU, Utrecht, the Netherlands
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  • Miriam Coccoris,

    1. Center for Clinical Transfusion Research, Sanquin Research
    2. Jon J. van Rood Center for Clinical Transfusion Research, Leiden University Medical Center, Leiden, the Netherlands
    3. Department of Clinical Chemistry and Haematology, UMCU, Utrecht, the Netherlands
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  • Jaap Jan Zwaginga,

    1. Center for Clinical Transfusion Research, Sanquin Research
    2. Jon J. van Rood Center for Clinical Transfusion Research, Leiden University Medical Center, Leiden, the Netherlands
    3. Department of Clinical Chemistry and Haematology, UMCU, Utrecht, the Netherlands
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  • Pieter F. van der Meer

    1. Center for Clinical Transfusion Research, Sanquin Research
    2. Jon J. van Rood Center for Clinical Transfusion Research, Leiden University Medical Center, Leiden, the Netherlands
    3. Department of Clinical Chemistry and Haematology, UMCU, Utrecht, the Netherlands
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  • This study was funded by Sanquin blood supply. The funding source had no role in study design, collection of data, analysis and interpretation of data, writing of the report, or the decision to submit.

Address reprint requests to: Rutger A. Middelburg, Center for Clinical Transfusion Research, Sanquin Research, Leiden, Plesmanlaan 1A, 2333 BZ Leiden, The Netherlands; e-mail: R.A.Middelburg@lumc.nl.

Abstract

Background

Platelet (PLT) function in PLT concentrates declines during storage and is further affected by pathogen reduction treatment. Flow cytometric assessment of agonist-induced P-selectin expression can be used to assess PLT function in patients with thrombocytopenia. The aim of this study was to evaluate how this functional test relates to established in vitro measures of PLT function.

Study Design and Methods

Six units of PLTs in plasma and 6 units of riboflavin and ultraviolet (Mirasol, TerumoBCT)-treated PLTs in plasma were sampled on Days 2, 6, 8, and 10 after donation. PLT concentration, Annexin 5A staining, ThromboLUX (LightIntegra) thrombelastography, and P-selectin expression, both in unstimulated PLTs and in response to concentration series of adenosine diphosphate, collagen-related peptide, and thrombin receptor–activating peptide (TRAP), were measured.

Results

For PLTs in plasma Annexin 5A expression increased by 0.60% (95% confidence interval [CI], 0.40%-0.80%) and P-selectin expression increased by 1.2% (95% CI, 0.80%-1.6%) per day. Responsiveness to TRAP simultaneously decreased by 1.3% (95% CI, 0.80%-1.8%) per day. After Mirasol treatment ThromboLUX scores decreased 3.3 points (95% CI, 0.2-6.4 points) from 22 to 19 points, Annexin 5A expression increased by 4.8% (95% CI, 3.3%-6.2%), and P-selectin expression increased by 13% (95% CI, 10%-16%), all averaged over the entire storage period. Responsiveness to TRAP simultaneously decreased by 19% (95% CI, 17%-21%).

Conclusions

Our results suggest flow cytometric measurement of agonist-induced P-selectin expression can measure PLT quality decline over the entire range encountered during 10-day storage of both standard PLTs and Mirasol-treated PLTs in plasma.

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