Phosphatidylserine exposure in platelet concentrates during the storage period: differences between the platelets collected with different cell separators

Abstract 

Background and objectives: Platelet alterations occur during the production and storage of platelet concentrates, the so called “storage lesion”. We studied the platelet alterations during the storage period in apheresis concentrates, employing flow cytometry for phosphatidylserine (PS) detection on platelets during the five days of storage.

Material and methods: Twenty-seven single donor platelet concentrates harvested with the Cobe Trima, Baxter Amicus, or Haemonetics MCS+ were analyzed for PS exposure by flow cytometry on the day of production (day 1) and on days 3 and 5 of storage. Furthermore PS expression was analyzed in platelet donors’ blood samples withdrawn before plateletpheresis.

Results: PS expression on platelets gave the following median values: in blood donors before apheresis it was 1.12% (0.13–1.78) in platelets concentrates on the first day (2 h after apheresis) 2.06% (0.66–15.2), the third day 6.57% (1.98–51.13) and the fifth day 23.04% (3.86–80.23). All differences between median values of PS expression in blood samples before apheresis, and platelets concentrates on days 1, 3 and 5 of storage, are statistically significant.

The expression of PS in platelet concentrates was analyzed in relation to the blood cell separator used for the collection procedure and showed the following results: on day 1 the median values of PS in platelet concentrates collected with the three different blood cell separators, Trima, Cobe and MCS, did not show statistically significant differences. On day 3, the platelets concentrates collected with the Trima and with the MCS showed differences that were statistically significant. Those were respectively 10.59% (4.56–51.13) and 3.53% (1.98–12.61), p=0.005. The PS expression in platelet concentrates collected with the Trima and MCS showed differences that are also statistically significant on day 5 at respectively 32.4% (9.61–80.23) and 8.57% (3.86–48.42), p=0.005.

Conclusions: PS exposure in platelet concentrates on days 3 and 5 rise to levels that could compromise the quality of the platelet units. Improvements in standardized platelet quality controls, and in platelet collection systems are required to reduce the storage lesions in platelets concentrates.

Keywords:  Platelet lesions, Storage lesions, Phosphatidylserine, Annexin V, Platelet storage