Effect of Interrupted Agitation and Removal of Leukocyte on Platelet Quality during the Storage of Platelet Concentrates

Sang Geun Roh; Ue Suk Joung; Won Chul Choi; Jai Ho Wee

doi:10.3343/kjlm.2008.28.3.221

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Roh, Joung, Choi, and Wee: Effect of Interrupted Agitation and Removal of Leukocyte on Platelet Quality during the Storage of Platelet Concentrates

Original Article

Korean J Leg Med 2008;28(3):221-229.

Published online: 14 February 2008

DOI: https://doi.org/10.3343/kjlm.2008.28.3.221

Effect of Interrupted Agitation and Removal of Leukocyte on Platelet Quality during the Storage of Platelet Concentrates

Sang Geun Roh, M.T.^1,², Ue Suk Joung, M.D.², Won Chul Choi, Ph.D.¹, Jai Ho Wee, M.D.²

¹Department of Biology, College of Natural Sciences, Pusan National University, Busan, Korea

²Busan Blood Center, Korea Red Cross, Busan, Korea

Received 30 January 200813 May 2008 Accepted 14 May 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

This study aimed to analyze the influence of the interruption of agitation and removal of leukocytes on platelet concentrates (PCs), and determine the maximum amount of time the agitation could be interrupted without impairing PCs’ effectiveness during the storage period.

Methods

Four ABO-identical random donor platelets agitated for 24 hr were pooled, and divided into 4 units, and 2 units of them were leukoreduced. Then 52 pooled units were categorized into 4 groups, non-leukoreduced continuous agitation (Non-LRCA), non-leukoreduced interrupted agitation (Non-LRIA), leukoreduced continuous agitation (LRCA), and leukoreduced interrupted agitation (LRIA), and preserved for 6 days (total 7 days). Mean platelet volume (MPV), pH, HCO₃⁻, pO₂, pCO₂, CD62P, CD61, glucose, lactate, ammonia and free fatty acid were measured during the period.

Results

Starting from the Day 4, the pH and HCO3⁻ of Non-LRIA group begun to decrease while the amount of lactate production, glucose consumption, and MPV increased compared to the Non-LRCA group (P<0.01). An increase in pO₂ level was observed in the interrupted agitation groups as the storage period prolonged (P<0.01). The pH levels of all the units in the agitation groups remained higher than 6.4 up to Day 7, while those of the non-leukoreduction group did so only up to Day 2, but those of leukoreduction in the interrupted agitation groups did so up to Day 4.

Conclusions

The interruption of agitation reduced the platelet's capacity to utilize oxygen, increasing lactate amount and reducing pH level. However, the in vitro parameters of the Non-LRIA and Non-LRCA groups on Day 2 were similar to each other and the pH level remained at 6.4 or higher, making one day of agitation interruption possible after 24 hr of agitation. With leukocytes removed, the effective agitation interruption period may become longer.

Keywords: Platelet concentrates, Interruption of agitation, Polyvinylchloride container, Platelet quality

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Fig. 1.

Metabolic measurements of platelets concentrations with a Non-LRCA (□), Non-LRIA (Δ), LRCA (▪) and LRIA (□) during the storage period. The results show mean standard deviation (SD) and error bars (n=13). (Glucose and Lactate: Day 4, 7 P<0.01) P values were calculated by Mann-Whitney test and compared between groups in the same storage period.

Day 1, Day 2, Day 4, Day 7, See Table 1.

Abbreviations: Non-LRCA, Non-LRIA, LRCA, LRIA, See Table 1.

Table 1.

Changes of in vitro parameters among groups during storage of platelet concentrates

	MPV (fL) (n=13)	HCO₃ (mmol/L) (n=13)	pO₂ (mmHg) (n=13)	pCO₂ (mmHg) (n=13)	pH (n=13)	CD62P (%) (n=13)
Day 1	6.6±0.31	17.3±1.24	67.6±44.55	61.7±8.24	7.25±0.09	0.47±0.26
Day 2
Non-LRCA	6.9±0.28	15.0±1.53	21.2±13.17	64.2±8.16	7.2±0.09	0.2±0.11
Non-LRIA	6.9±0.27	13.8±1.74	28.0±22.93^∗	71.6 ± 11.64^‡	7.1±0.12	0.3±0.17
	P=0.390	P=0.057	P=0.614	P=0.057	P=0.050	P=0.977
LRCA	6.8±0.22	15.1±1.09	55.8±42.33	51.5±7.37	7.3±0.008	0.3±0.24
LRIA	6.8±0.28	14.2±1.41	54.6 ±41.32^†	55.1 ±10.50^‡	7.2±0.12	0.3±0.15
	P=0.390	P=0.223	P=0.920	P=0.418	P=0.243	P=0.932
Day 4
Non-LRCA	7.0±0.19	10.5±2.47	25.4±18.90	51.8±4.04	7.1±0.13	0.3±0.20
Non-LRIA	7.6±0.44^‡	5.1 ±2.56^§	47.5±24.10^∗	61.5 ±8.00^†	6.65 ±0.25^‡	0.5±0.32
	P=0.000	P=0.000	P=0.017	P=0.004	P=0.000	P=0.319
LRCA	7.0±0.25	11.3±1.68	59.8±39.60	42.5±7.10	7.22±0.10	0.4±0.19
LRIA	7.1 ±0.33^‡	8.1 ±3.08^§	65.9 ±33.26^‡	50.0 ±9.60^†	7.00 ±0.26^†	0.4±0.25
	P=0.479	P=0.003	P=0.579	P=0.016	P=0.004	P=0.630
Day 7
Non-LRCA	7.1±0.23	5.7±1.72	24.3±18.05	44.0±3.95	6.89±0.17	1.0±0.87
Non-LRIA	7.9±0.33	0.3±0.54^§	149.5 ±34.18^∗,§	14.4±8.91^§	5.95 ±0.30^‡	7.8±4.94
	P=0.000	P=0.000	P=0.000	P=0.000	P=0.000	P=0.000
LRCA	7.1±0.20	6.8±1.15	60.2±40.56	36.7±7.39	7.07±0.14	1.4±1.23
LRIA	7.6±0.37	2.5±2.36^§	107.2±45.65^†,§	24.8±10.51^§	6.51 ±0.51^†	4.0±5.75
	P=0.000	P=0.000	P=0.007	P=0.001	P=0.001	P=0.525

Day 1, right after pooling; Day 2, one day after pooling; Day 4, three day after pooling; Day 7, 6 day after pooling.

P values were calculated by Mann-Whitney test and compared between groups in the same storage period.

^∗,† P<0.05; calculated by Kruskal-Wallis test and compared within the same group on Day 2, Day 4 and Day 7.

^‡ P<0.01,

^§ P<0.05; calculated by Mann-Whitney’ test and compared between groups in the same storage period.

Abbreviations: MPV, mean platelet volume; Non-LRCA, non-leukoreduced/continuous agitation (control); Non-LRIA, non-leukoreduced/interrupted agitation; LRCA, leukoreduced/continuous agitation; LRIA, leukoreduced/interrupted agitation.

Table 2.

Correlation analysis of in vitro parameters according to pH change

	HCO₃ (mmol/L)		Glucose (mmol/L)		Lactate (mmol/L)		CD62P (%)
	γ_sp	P-value	γ_sp	P-value	γ_sp	P-value	γ_sp	P-value
Day 2
Non-LRCA	0.898	0.000	0.382	0.197	-0.918	0.000	0.161	0.618
Non-LRIA	0.941	0.000	0.572	0.041	-0.791	0.001	0.140	0.664
LRCA	0.630	0.020	0.454	0.119	-0.830	0.000	0.042	0.897
LRIA	0.779	0.002	0.455	0.119	-0.868	0.000	0.119	0.713
Day 4
Non-LRCA	0.975	0.000	0.762	0.004	-0.923	0.000	-0.291	0.385
Non-LRIA	0.995	0.000	0.923	0.000	-0.909	0.000	-0.519	0.102
LRCA	0.683	0.010	0.715	0.006	-0.923	0.000	-0.231	0.470
LRIA	0.988	0.000	0.907	0.000	-0.967	0.000	-0.263	0.409
Day 7
Non-LRCA	0.946	0.000	0.654	0.015	-0.610	0.027	-0.091	0.779
Non-LRIA	0.818	0.001	0.862	0.000	-0.682	0.010	-0.716	0.009
LRCA	0.824	0.001	0.718	0.006	-0.495	0.086	0.168	0.601
LRIA	0.979	0.000	0.989	0.000	-0.934	0.000	-0.618	0.043

P values were calculated by Spearman correlation analysis test and compared with the pH level within the same group in the same storage period.

Day 2, Day 4, Day 7, See Table 1.

Abbreviations: γ_Sp, Spearman correlation coefficient; Non-LRCA, Non-LRIA, LRCA, LRIA, See Table 1.

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