Advanced
Plateletpheresis: the Process, Devices, and Indicators of Product Quality
Plateletpheresis: the Process, Devices, and Indicators of Product Quality
Journal of Life Science. 2014. Sep, 24(9): 1030-1038
Copyright © 2014, Korean Society of Life Science
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.
  • Received : June 20, 2014
  • Accepted : July 25, 2014
  • Published : September 30, 2014
Download
PDF
e-PUB
PubReader
PPT
Export by style
Share
Article
Author
Metrics
Cited by
TagCloud
About the Authors
철수 장
성인 김
현경 김
창오 권
병원 김
동찬 김
윤석 김
기종 이
재기 류
rs0429@hanmail.net

Abstract
Platelet products are used to treat hemorrhagic or platelet dysfunction diseases. Plateletpheresis involves collecting the platelet components of blood using an apheresis blood-collection system. Various indicators are available for evaluating the qualities of the apheresis platelets. The productivity of platelet collection is evaluated through both the collection efficiency and collection rates. Platelet storage quality can be evaluated in vitro using several indicators, including visual appearance, metabolic activities, volume, platelet count, white blood cell count, microparticles, and various platelet activation markers. Platelet activation markers have been used as indicators of storage quality in various studies. Post-transfusion platelet quality can be evaluated based on the corrected count increment and the percentage of platelet recovery. Although various studies have investigated the aspects of plateletpheresis, no article has systemically presented assessments of the platelet products obtained from different plateletpheresis devices. The present study provides a review of plateletpheresis, including the specifics of the process, the types of devices employed, the platelet quality, the overall efficacy, and the evaluation indicator qualities. Furthermore, the differences in functionality among the different apheresis devices are discussed. Although adverse reactions to the citrate anti-coagulant have been reported, apheresis processing may provide a safer option for donors who are at a high risk for presyncopal or syncopal reactions related to whole blood collection.
Keywords
Introduction
Apheresis is the process of collecting blood components such as plasma, platelets, red blood cells, and granulocytes from donor blood. The term “apheresis” is derived from the Latin word “aphaeresis”, which means “withdrawal”. Apheresis is accomplished using an apheresis instrument termed a cell separator. Whole blood from the donor is separated by the device through centrifugation, based on the specific gravity and/or filtration parameters. The selected component of the blood is retained, while remaining blood components are returned to the donor through automated circulation. The processing time is approximately 1-2 hr [7 , 24] . Apheresis instruments are used with various settings, depending on the specific needs of different cases [8] . Cell separators employ either continuous flow centrifugation, which uses 2 venipunctures to collect blood, or intermittent flow centrifugation, which returns the unwanted blood components to the donor after it is temporarily collected in the cell separator. In practice, apheresis presents several obstacles. For example, apheresis requires a trained cell separator operator; is difficult to apply in high-capacity, emergency settings; requires large initial expenditures; and can result in adverse reactions among donors, such as paresthesia, tingling, seizure, and muscle cramps. These adverse reactions result from the use of citrate anticoagulants during apheresis. Nonetheless, the collection and use of blood components through apheresis has increased over the past few decades. The transfusion of blood components collected through apheresis has many benefits. Indeed, it provides larger quantities of components than does whole blood separation, produces consistent product volumes, makes efficient use of the same donor, reduces the donor’s physical stress and blood cell count recovery times, and decreases the risk of bacterial contamination. By eliminating the recipient’s exposure to multiple donors, apheresis additionally reduces the risks of human leukocyte antigen (HLA) alloimmunization and transfusion-transmitted diseases [3 , 8 , 15 , 24 , 41 , 63] .
Platelets are anucleate blood cells (150-450×10 3/μ l) that form a platelet plug by adhesion and aggregation, thereby contributing to hemostasis [14] . Platelets are transfused for (i) treating hemorrhage due to severe thrombocytopenia, (ii) increasing platelet counts that are less than 20,000 per μl, or (iii) treating platelet dysfunction disease [40 , 55] . Plateletpheresis is the process of collecting the platelet component through apheresis. Various studies have investigated the aspects of apheresis platelet products, including quality evaluation, efficacy, the comparative performance of different devices, and methods designed for different patient symptoms. However, to our knowledge, no article has systematically presented assessments of the quality and efficacy of platelets obtained from different plateletpheresis instruments. In the present review, we address the quality and efficacy of apheresis platelets.
Current Status of Methods and Results
- Donor screening for plateletpheresis
With the exception of the donation interval, the requirements for apheresis and whole blood donation are the same. Apheresis donors must meet the requirements for whole blood donation and additionally satisfy criteria that are particular to the selected apheresis. Donor screening is required to ensure a safe transfusion for the recipient. Prospective donors must complete several steps before actual blood donations, including physical examination, a donor history questionnaire, and testing for transmissible diseases. The American Association of Blood Banks (AABB) recommends that prospective donors receive physical examinations including an assessment of weight: hemoglobin, hematocrit, ABO and Rh typing: and inspection for marks from intravenous drug use. Tests are performed for the presence of syphilis, human immunodeficiency virus (anti- HIV-1/2 and HIV-1 RNA), hepatitis C virus (anti-HCV and HCV RNA), hepatitis B virus (HBsAg and anti-HBc), human T-cell lymphotropic viruses I and II (anti-HTLV-I/II), Trypanosoma cruzi (anti- Trypanosoma cruzi ), and West Nile virus (West Nile virus RNA). The Korean Society of Blood Transfusion recommends the tests for ABO and Rh typing, ABO subtyping, ALT, Total Protein, Antibody Screening Test, HBV (HBs Ag, HBV-NAT), HCV (anti-HCV, HCVNAT), HIV (anti-HIV, HIV-NAT), anti-HTLV, anti-Syphilis, and anti-Malaria for the donated blood.
Further, the platelet counts of plateletpheresis donors must be >150×10 3 per μl [32] . Individuals can donate 3 days after ingesting aspirin-related medications.
- Plateletpheresis instruments
Plateletpheresis instruments include the Fenwal CS3000 and Fenwal CS3000+ (Baxter Healthcare Corp., Round Lake, IL, USA); Fenwal Amicus (Fenwal, Inc., Lake Zurich, IL, USA); Cobe Spectra (Terumo BCT, Lakewood, CO, USA); Fresenius AS104 and Fresenius COM.TEC (Fresenius AG, Bad Homburg, Germany); Trima (Version 4) and Trima Accel (Terumo BCT, Lakewood, CO, USA); and Haemonetics MCS LN9000 and MCS+LN3000 (Haemonetics Corp., Stoughton, MA, USA). These different devices have been compared according to a variety of measures, including platelet yield, collection efficiency, and collection rates [3 , 8 , 9 , 10 , 58] .
- Platelet yield
The platelet volume collected by plateletpheresis ranges from 150 to 300 ml and 75% of the collection must meet the standard of 3×10 11 platelets/unit. Platelet yields in excess of 6×10 11 present several advantages. For example, when large quantities of platelets can be collected from donors who have been matched with patients according to HLA type, the collected blood can be divided into two parts and used [5] . Burgstaler et al. [9] reported that plateletpheresis with a double-needle Amicus provided more double units than did Cobe Spectra double-needle version 5 leukoreduction systems, Cobe Spectra double-needle version 7 leukoreduction systems, or Fresenius AS 104. The frequency of double units is 65% when Amicus or Trima Accel is used [9 , 10] . If pre-donation platelet counts are high, platelet yields are generally high as well.
- Reduction of white blood cell count
If a recipient’s white blood cells (WBCs) are exposed to donor WBCs, allogenic immune reactions may result in complications. In such cases, the leukoreduction process is employed to reduce the complications that were induced by the transfusion. The choice of leukoreduction is motivated by several major goals: reducing febrile non-hemolytic transfusion reactions, diminishing HLA sensitization and platelet refractoriness, reducing the rate of cytomegalovirus infection, and reducing the rate of transfusion-associated graft versus host disease [33 , 48] . Newly developed apheresis instruments have built-in leukoreduction systems that eliminate the need for further, post-apheresis reduction of leukocytes counts. Leukoreduced blood products are required to meet AABB, which indicate that WBC counts per unit must be <5×10 6 .
- Collection efficiency, collection rates, and WBC count
Evaluations of platelet collection performance are based on collection efficiency (CE) and collection rate (CR). CE compares the number of platelets in the collection bag with the number of platelets that pass through the device. Is calculated according to the following formulas:
  • CE = platelet yields in collection bag (1011) ×100/average platelet count × blood volume processed.
  • Average platelet count = (pre-apheresis platelet count + post-apheresis platelet count)/2
  • Blood volume processed = total blood volume processed − volume of anticoagulant
CR is defined as the platelet yield per minute of processing time. However, it does not reflect the time that is required to collect platelets. To estimate the time to collect required quantities of platelets, it is necessary to have the CRs for the instruments that are being used. CR is determined by the following formula:
  • CR = platelet yields in a collection bag (1011)/min of processing time
Various studies have compared the function and characteristics of different apheresis instruments. Table 1 summarizes previous reports of CE, CR, and WBC for different apheresis equipment. According to these reports, the single- needle Amicus and single-needle Trima Accel have the highest CE and CR [3 , 8 , 9 , 10 , 58] . Flesch et al. [21] reported that the double-needle Amicus and the single-needle Trima Accel showed similar platelet yields and donation times.
Collection efficiency (CE), collection rates (CR), and white blood cell (WBC) content for samples obtained from different plateletpheresis instruments
PPT Slide
Lager Image
AS104: Fresenius AS104 double-needle, AMDN: Amicus double-needle, V7-LRS: Cobe Spectra double-needle version 7 leukoreduction system, V5-LRS: Cobe Spectra double-needle version 5 leukoreduction system, AMSN: Amicus single-needle, TASN: Trima Accel single-needle, CT4DN: COM.TEC version4, CS3000+: Fenwal CS3000+, N: number of donation, PLT yield: median platelet count of plateletpheresis product, CE: median collection efficiency, CR: median collection rates. [ ]: reference number
- Quality evaluation indicators of apheresis platelet
Platelet products that are stored at room temperature (20-24℃) with agitation may remain viable for 5 days [32] . The storage time allowed by the US Food and Drug Administration (FDA) was increased to 7 days in 1984, but returned to 5 days in 1986 because of events of bacterial transmission by transfused platelets. Slichter et al. [55] reported in vivo platelet recovery and survival in a platelet product obtained from MCS+ LN 9,000 and stored for 8 days. The quality of platelets that are stored after donation is influenced by many factors, including differences in blood component processing, gas permeability of the storage bag, anticoagulants, agitation, and storage temperature [4 , 38 , 56] . Platelet quality can be evaluated in vitro using several parameters such as visual appearance, metabolic activity, volume, platelet count, and WBC count per unit. After transfusion, platelet quality can be evaluated using corrected count increment (CCI) and percentage platelet recovery (PPR) [27 , 54] .
- Visual appearance
The visual appearance of platelets, such as evidence of swirling, is used to evaluate platelet functionality [34] . Swirling is caused by the reflection of light when a discoid platelet is exposed to a light source. Generally, platelet concentrate with a pH of 6.7-7.5 will show swirling when the platelets retain their discoid shape in vitro at the time of transfusion, and are expected to be functional in vivo [6 , 34] . Singh et al. [54] found that apheresis-platelet concentrate units from the CS3,000+ instrument showed better swirling and platelet counts than platelet rich plasma-platelet concentrates; however, Mintz et al. [37] confirmed that spherical platelets may revert to the discoid form, and that non-discoid platelets may retain suitable functionality post-transfusion.
- Metabolic activity
Metabolic activities of apheresis platelets are mainly measured using pH, pCO 2 , pO 2 , bicarbonate, glucose, lactate, adenosine triphosphate (ATP), and hypotonic shock response (HSR).
The AABB requires that the pH of the platelet products remains ≥6.2 during storage with agitation at 20-24℃. During storage, pH decreases as a result of increased lactic acid production due to glycolysis. At pH 6.0, the platelets irreversibly transition from the discoid to the spherical form [39] . Accordingly, pH has been identified as an indicator of stored platelet functionality. However, Tudisco et al. [59] found that pH had little utility for the quality control of platelets produced by MCS + LN 3,000, Amicus, and CS-3,000+ apheresis instruments. Most platelet products obtained from apheresis collections have a pH ≥6.2 on day 5 of storage, and the pH may even exceed 7.0 at 7 days of storage [18 , 20 , 26 , 45 , 55] .
Assessments of pCO 2 , pO 2 , and bicarbonate changes in apheresis platelets showed that pCO 2 and bicarbonate were both significantly reduced in all platelet concentrates collected using MCS+ LN9,000 or Trima instruments. However, differences in pO 2 were observed to increase or decrease, depending on the sample. Results were not significant in platelets from Trima that had been stored 7-9 days. Furthermore, in apheresis platelets, glucose levels decrease and lactate significantly increases during storage [18 , 20 , 26 , 45 , 55] .
ATP is the major energy source for platelet survival. Naturally, ATP also decreases significantly during storage [18] . ATP was reduced in platelet concentrates collected using Trima [18 , 20 , 45] .
HSR measures the capacity of platelets that have been restored to normal morphology after hypotonic shock due to the addition of hypotonic solution. HSR is regarded as a predictor of platelet functionality [20 , 46] . The HSR of apheresis platelets decreases as storage times increase [20 , 26 , 45 , 55] .
- Microparticles (MPs)
MPs are membrane vesicles that originate primarily from platelets (PMP) or endothelial cells (EMP). The level of PMP generally increases in plateletpheresis concentrates during storage because PMPs are released by activation [43 , 47 , 52 , 61] . The aim of plateletpheresis is to reduce HLA sensitization through leukodepletion: however, platelets that are collected primarily from plateletpheresis contain MPs, including EMP, which have high densities of HLA antigen [47 , 50] . Therefore, improvements in apheresis technology may be necessary to reduce MP loads.
- Platelet activation
Platelets play 2 key roles in hemostasis: platelet adhesion to exposed subendothelial membrane and platelet aggregation among activated platelets result in platelet plug formation. Negatively charged platelet surfaces promote the activation of coagulation factors II and X [8 , 39] . Various studies have investigated platelet activation, which has been used to evaluate platelet quality during processing and storage of plateletpheresies products. Activated platelet markers that have been used in studies of plateletpheresis include P-selectin (CD62P) [2 , 27 , 30] , CD63 [20 , 22 , 47] , glycoprotein (GP)Ibα [25 , 30 , 36] , CD40 ligand (CD40L, CD154) [12 , 13 , 19 , 28 , 62] , and coated platelets [1 , 11 , 57] .
P-selectin (CD62P) is stored in granules of endothelial cells and platelets. It is expressed on the surface of activated cells, where it functions as a cell adhesion molecule [2 , 30] . During storage, increased P-selectin expression on activated platelet surfaces triggers rapid clearance of transfused platelets from circulation. Comparisons of platelet concentrates obtained from different apheresis instruments have demonstrated that the double-needle Amicus has higher rates of P-selectin-positive platelets than does the single-needle Trima Accel: this suggests that increased P-selectin expression may result from delayed processing times within the apheresis device [27 , 30] .
GPIbα is a platelet adhesion molecule that interacts with von Willebrand factor bound at damaged sites of blood vessels [25] . GPIbα may function as a platelet activation marker, as does P-selectin [30 , 36] . GPIbα of activated platelets is redistributed from the platelet surface to the internal membrane during conventional storage: as storage time increases, GPIb levels of platelet surface decrease. During storage of the platelet concentrates, platelet products from the Haemonetics PCS-Plus change less than those from platelet- rich plasma [36] .
CD63 is a 53-kDa lysosomal membrane glycoprotein that is translocated to the plasma membrane after platelet activation. It is considered to be a platelet activation marker [23] . Gutensohn et al. [22] reported that the CD63 levels of platelets collected using Amicus, Cobe Spectra, and Trima devices increased after storage for 5-8 days [20 , 47] .
CD40L, a member of the tumor necrosis factor family, is a trimeric transmembrane protein that is mainly contained within platelets [12 , 28] . CD40L is generally sequestered inside resting platelets. However, it translocates to the cell surface after activation, and is subsequently cleaved from the platelet surface to generate soluble CD40L (sCD40L). Therefore, increased sCD40L levels can provide a marker of platelet activation [12 , 13 , 19 , 28 , 62] . Platelet products that are collected with MCS+, Trima Accel, and Amicus instruments show increased sCD40L levels during storage [19 , 28 , 62] . Further, the sCD40L levels of platelet products that are collected using the Amicus or Gambro instruments do not differ substantially the sCD40L levels of platelet products that are prepared from whole blood. Coated platelets provide another marker of platelet activation. Coated platelets are activated by collagen and thrombin, representing approximately 30% of the total platelet population [1 , 11] . The surfaces of coated platelets contain procoagulants [1 , 11] . The percentage of coated platelets that is obtained from whole blood and apheresis products decreases as post-production storage time increase. The plateletpheresis method has also been observed to influence platelet activation; in addition to the storage phase itself, the plateletpheresis process conducted with the Trima Blood Collection System decreases the number of coated platelets [11 , 57] . Table 2 presents the changes in metabolic activity during apheresis platelet storage [11 , 55 , 59] .
Changes in the function and metabolic activity of apheresis platelets after storage
PPT Slide
Lager Image
Changes in the function and metabolic activity of apheresis platelets after storage
- CCI and PPR
When evaluating the in vivo recovery and survival of post-transfusion platelets, CCI and PPR are routinely used to determine the response to platelet transfusions in vivo , as well as to assess platelet transfusion refractoriness. CCI and PPR are calculated according to the following formulas [27 , 44] .
  • CCI = (platelet increment/μl) × (body surface area in m2)/number of platelets transfused (×1011)
  • PPR = (platelet count increment/μl) × blood volume (ml) × 103/number of platelets transfused
Successful platelet transfusion is defined as a CCI greater than 7,500 platelets × m 2 /μl and a PPR greater than 30% within 1 hour of transfusion [44] . In a quality evaluation of apheresis platelet products, Pandey et al. [44] found that use of the COM.TEC instrument provided an optimal response to platelet transfusion, in terms of both CCI and PPR values. However, Julmy et al. [27] reported that the transfusion efficacy of the double-needle Amicus was significantly lower than that of the single-needle Trima Accel. Julmy et al. [27] considered this finding to be a consequence of high platelet concentrations or increased platelet activation, showing that Amicus is not suitable for high-yield plateletpheresis (≥6.0×10 11 ). However, CCI and PPR results are sensitive to the recipient’s medical state and the apheresis process [51] . It has been observed that alloimmunized patients have difficulty managing their thrombocytopenia after platelet transfusion, and are refractory to fresh allogeneic platelets [42 , 60] . Additionally, some studies have found decreased CCI values using platelet additive solution (PAS), and further, it has been observed that all patients who were refractory to fresh allogeneic platelet transfusion had successful CCI results to autologous cryopreserved platelets [16 , 29 , 60] . Table 3 presents the transfusion efficacy of apheresis platelets according to different approaches to apheresis, which showed that the successful platelet transfusion in all apheresis instruments.
Transfusion efficacy after transfusion of apheresis-platelet concentrates
PPT Slide
Lager Image
AMDN: Amicus double-needle, TASN: Trima Accel single-needle Cobe Spectra: Cobe Spectra version 4.0autologous: cryopreserved in ThromboSol and 2% dimethyl sulfoxide [ ]: reference number
- Effect of PAS
When processing the platelet component, the use of a PAS to suspend the platelet concentrates (instead of plasma) may reduce the incidence of adverse reactions due to plasma [17 , 53] . In a quality comparison of extended platelet storage (up to 9 days) using the different Trima systems, it was found that platelets collected in PAS were more likely to retain acceptable metabolic and cellular characteristics than platelets collected in plasma-stored apheresis units [26] . However, some studies have reported that platelets suspended in PAS show significantly lower CCI than platelets suspended in plasma [16 , 29] . Table 4 presents details of the changes in metabolic activity of apheresis platelet according to the use of different additive solutions when the same device is used [18 , 26 , 45] . PAS can affect the functionality of apheresis platelets during storage.
Changes in metabolic activity of apheresis platelet according to the use of different additive solutions
PPT Slide
Lager Image
Trima: Trima AccelM: pathogen reduction technology (PRT) treatment with the Mirasol PRT system C: Mirasol PRT system untreated control [ ]: reference number
- Donor adverse reactions
In the apheresis collection process, the most common donor adverse reactions are related to citrate toxicity [31 , 35] . Symptoms including tingling, paresthesia, and muscle cramps can result from citrate reactions [63] . Benjamin et al. [5] reported that plateletpheresis using an Amicus instrument required larger quantities of acid citrate dextrose than did plateletpheresis using a Cobe Spectra instrument. Benjamin et al. [5] further reported than use of the Amicus instrument resulted in greater rates of citrate toxicity among apheresis donors. However, citrate-induced adverse events that result from apheresis processing can be treated with calcium supplementation or reductions in the quantity of anticoagulant that is employed. Compared with whole blood collection, blood collection using apheresis may be a safer option for donors who have risk factors for presyncopal or syncopal reactions related to whole blood collection [3 , 63] . Relevant risk factors include younger age, female gender, and small total blood volume.
Conclusion
Plateletpheresis has become more popular because single- donor platelet products reduce the incidence of adverse reactions and increase the efficiency of blood usage. Various studies have evaluated the quality of platelet products during apheresis platelet storage. Quality can be assessed using platelet functionality markers such as visual appearance, metabolic activity, MPs, platelet activation, CCI, and PPR. In particular, various markers of platelet activation have been developed and used for studies related to cell activation. The quality of platelets can also be influenced by the processing method and additive solutions. Additionally, apheresis may provide substantial benefits for donors who have risk factors for presyncopal or syncopal reactions related to whole blood collection.
References
Alberio L. , Safa O. , Clemetson K. J. , Esmon C. T. , Dale G. L. 2000 Surface expression and functional characterization of α-granule factor V in human platelets: effects of ionophore A23187, thrombin, collagen, and convulxin Blood 95 1694 - 1702
Altuntas F. , Sari I. , Kocyigit I. , Kaynar L. , Hacioglu S. , Ozturk A. , Oztekin M. , Solmaz M. , Eser B. , Cetin M. , Unal A. 2008 Comparison of plateletpheresis on the Fenwal Amicus and Fresenius Com.Tec cell separators Transfus Med Hemother 35 368 - 373
Berger G. , Hartwell D. W. , Wagner D. D. 1998 P-selectin and platelet clearance Blood 92 4446 - 4452
Baldini M. , Costea N. , Dameshek W. 1960 The viability of stored human platelets Blood 16 1669 - 1692
Benjamin R. J. , Rojas P. , Christmas S. , Neal J. , Broughton S. , Burgio C. , Barrett B. , Churchill W. H. 1999 Plateletpheresis efficiency: a comparison of spectra LRS and Amicus separators Transfusion 39 895 - 899
Bertolini F. , Murphy S. 1996 A multicenter inspection of the swirling phenomenon in platelet concentrates prepared in routine practice. Biomedical excellence for safer transfusion (BEST) working party of the international society of blood transfusion Transfusion 36 128 - 132
Blaney K. D. , Howard P. R. 2008 Basic and applied concepts of immunohematology 2nd ed. Mosby Elsevier St. Louis, Missouri, USA 219 -
Burgstaler E. A. 2006 Blood component collection by apheresis J Clin Apher 21 142 - 151
Burgstaler E. A. , Pineda A. A. , Bryant S. C. 1999 Prospective comparison of plateletapheresis using four apheresis systems on the same donors J Clin Apher 14 163 - 170
Burgstaler E. A. , Winters J. L. , Pineda A. A. 2004 Paired comparison of Gambro Trima Accel versus Baxter Amicus single-needle plateletpheresis Transfusion 44 1612 - 1620
Charania R. , Smith J. , Vesely S. K. , Dale G. L. , Holter J. 2011 Quantitation of coated platelets potential during collection, storage, and transfusion of apheresis platelets Transfusion 51 2690 - 2694
Choi W. S. , Jeon O. H. , Kim D. S. 2010 CD40 ligand shedding is regulated by interaction between matrix metalloproteinase- 2 and platelet integrin αIIbβ3 J Thromb Haemost 8 1364 - 1371
Danese S. , Katz J. A. , Saibeni S. , Papa A. , Gasbarrini A. , Vecchi M. , Fiocchi C. 2003 Activated platelets are the source of elevated level of soluble CD40 ligand in the circulation of inflammatory bowel disease patients Gut 52 1435 - 1441
Dale G. L. 2005 Coated-platelets: an emerging component of the procoagulant response J Thromb Haemost 3 2185 - 2192
Densmore T. L. , Goodnough L. T. , Ali S. , Dynis M. , Chaplin H. 1999 Prevalence of HLA sensitization in female apheresis donors Transfusion 39 103 - 106
de Wildt-Eggen J. , Gulliksson H. 2003 In vivo and in vitro comparison of platelets stored in either synthetic media or plasma Vox Sang 84 256 - 264
de Wildt-Eggen J. , Nauta S. , Schrijver J. G. , van Marwijk Kooy M. , Bins M. , van Prooijin H. C. 2000 Reactions and platelet increments after transfusion of platelet concentrates in plasma or an additive solution: a prospective, randomized study Vox Sang 40 398 - 403
Diab Y. A. , Thomas A. T. , Luban N. L. C. , Wong E. C. C. , Wagner S. J. , Levy R. J. 2012 Acquired cytochrome C oxidase impairment in apheresis platelets during storage: a possible mechanism for depletion of metabolic adenosine triphosphate Transfusion 52 1024 - 1030
Diab Y. , Wong E. , Criss V. R. , Moroff C. G. , Wagner S. J. , Luban N. L. C. 2011 Storage of aliquots of apheresis platelets for neonatal use in syringes with and without agitation Transfusion 51 2642 - 2646
Diedrich B. , Sandgren P. , Jansson B. , Gulliksson H. , Svensson L. , Shanwell A. 2008 In vitro and In vivo effects of potassium and magnesium on storage up to 7 days of apheresis platelet concentrates in platelet additive solution Vox Sang 94 96 - 102
Flesch B. K. , Adamzik I. , Steppat D. , Miller J. , Carstensen L. , Schapke M. , Davey J. 2010 Paired crossover study of two plateletpheresis systems concerning platelet product quality and donor comfort Transfusion 50 894 - 901
Gutensohn K. , Geidel K. , Kroeger N. , Eifrig B. , Crespeigne N. , Kuehnl. P. 2002 Platelet function testing in apheresis products: flow cytometric, resonance thrombographic (RTG) and rotational thromboelastographic (roTEG) analyses Transfus Apher Sci 26 147 - 155
Hamamoto K. , Ohga S. , Nomura S. , Yasunaga K. 1994 Cellular distribution of CD63 antigen in platelets and in three megakaryocytic cell lines Histochem J 26 367 - 375
Hillyer C. D. , Silberstein L. E. , Ness P. M. , Anderson K. C. , Roback J. D. 2006 Blood banking and transfusion medicine: Basic Principles & Practice 2nd ed. Churchill Livingstone, Elsevier Philadelphia, PA, USA 72 -
Hoffmeister K. M. , Felbinger T. W. , Falet H. , Denis C. V. , Bergmeier W. , Mayadas T. N. , von Andrian U. H. , Wagner D. D. , Stossel T. P. , Hartwig J. H. 2003 The clearance mechanism of chilled blood platelets Cell 112 87 - 97
Johnson L. , Winterm K. M. , Hartkopf-Theis T. , Reid S. , Kwok M. , Marks D. C. 2012 Evaluation of the automated collection and extended storage of apheresis platelets in additive solution Transfusion 52 503 - 509
Julmy F. , Ammann R. A. , Taleghani B. M. , Fontana S. , Hirt A. , Leibundgut K. 2008 Effects of high-yield thrombocytapheresis on the quality of platelet products Transfusion 48 442 - 450
Kaufman J. , Spinelli S. I. , Schultz E. , Blumberg N. , Phipps R. P. 2007 Release of biologically active CD154 during collection and storage of platelet concentrates prepared for transfusion J Thromb Haemost 5 788 - 796
Kerkhoffs J. L. , Eikenboom J. C. , Schipperus M. S. , van Wordragen-Vlaswinkei R. J. , Brand R. , Harvey M. S. , de Vries R. R. , Barge R. , van Rhenen D. J. , Brand A. 2006 A multicenter randomized study of the efficacy of transfusions with platelets stored in platelet additive solution II versus plasma Blood 108 3210 - 3215
Leytin V. , Allen D. J. , Gwozdz A. , Garvey B. , Freedman J. 2004 Role of platelet surface glycoprotein Ibα and P-selectin in the clearance of transfused platelet concentrates Transfusion 44 1487 - 1495
Maker Y. F. , Butler M. O. , Cockersole G. M. , Gabra G. , Serevitch J. M. 2002 National audit of citrate toxicity in plateletpheresis donors Transfus Med 12 187 - 191
Makroo R. N. , Kumar P. 2006 Platelet transfusion in clinical medicine Apollo Medicine 3 298 - 300
Marschner S. , Fast L. D. , Baldwin W. M. 3rd. , Slichter S. J. , Goodrich R. P. 2010 White blood cell inactivation after treatment with riboflavin and ultraviolet light Transfusion 50 2489 - 2498
Mathai J. , Resmi K. R. , Sulochana P. V. , Sathyabhama S. , Baby Saritha G. , Krishnan L. K. 2006 Suitability of measurement of swirling as a marker of platelet shape change in concentrates stored for transfusion Platelets 17 393 - 396
McLeod B. C. , Price T. H. , Owen H. , Ciavarella D. , Sniecinski I. , Randels M. J. , Smith J. W. 1998 Frequency of immediate adverse effects associated with apheresis donation Transfusion 38 938 - 943
Metcalfe P. , Williamson L. M. , Reutelingsperger C. P. , Swann I. V. , Ouwehand W. H. , Goodall A. H. 1997 Activation during preparation of therapeutic platelets affects deterioration during storage: a comparative flow cytometric study of different production methods Br J Haematol 98 86 - 95
Mintz P. D. , Anderson G. , Avery N. , Clark P. , Bonner R. E. 2005 Assessment of the correlation of platelet morphology with in vivo recovery and survival Transfusion 45 72 - 80
Murphy S. , Gardner F. H. 1969 Effect of storage temperature on maintenance of platelet viability-deleterious effect of refrigerated storage N Engl J Med 280 1094 - 1098
Murphy S. , Gardner F. H 1975 Platelet storage at 22℃: role of gas transport across plastic containers in maintenance of viability Blood 46 209 - 218
Navarro J. T. , Hernandez J. A. , Ribera J. M. , Sancho J. M. , Oriol A. , Pujol M. , Milla F. , Feliu E. 1998 Prophylactic platelet transfusion threshold during therapy for adult acute myeloid leukaemia:10000/cumm versus 20000/cumm Haematologica 83 998 - 1000
Ness P. M. , Campbell-Lee S. A. 2001 Single donor versus pooled random donor platelet concentrates Curr Opin Hematol 8 392 - 396
Novotný V. M. , Doxiadis II. , Brand A. 1999 The reduction of HLA class I expression on platelets: a potential approach in the management of HLA-alloimmunized refractory patients Transfus Med Rev 13 95 - 105
Ohto H. , Nollet K. E. 2011 Overview on platelet preservation: Better controls over storage lesion Transfus Apher Sci 44 321 - 325
Pandey P. , Tiwari A. K. , Sharma J. , Singh M. B. , Dixit S. , Vimarsh Raina V. 2012 A prospective quality evaluation of single donor platelets (SDP)-An experience of a tertiary healthcare center in India Transfus Apher Sci 46 163 - 167
Picker S. M. , Tauszig M. E. , Gathof B. S. 2012 Cell quality of apheresis-derived platelets treated with riboflavin-ultraviolet light after resuspension in platelet additive solution Transfusion 52 510 - 516
Plaza E. M. , Lozano M. L. , Guiu I. S. , Egea J. M. , Vicente V. , De Tarán L. C. , Rivera J. 2012 Evaluation of platelet function during extended storage in additive solution, prepared in a new container that allows manual buffy-coat platelet pooling and leucoreduction in the same system Blood Transfus 10 480 - 489
Rank A. , Nieuwland R. , Liebhardt S. , Iberer M. , Grutzner S. , Toth B. , Pihusch R. 2011 Apheresis platelet concentrates contain platelet-derived and endothelial cell-derived microparticles Vox Sang 100 179 - 186
Ratko T. A. , Cummings J. P. , Oberman H. A. , Crookston K. P. , DeChristopher P. J. , Eastlund D. T. , Godwin J. E. , Sacher R. A. , Yawn P. H. , Matuszewski K. A. 2001 Evidence-based recommendation for the use of WBC-reduced cellular blood components Transfusion 41 1310 - 1319
Rock G. , Moltzan C. , Alharbi A. , Giulivi A. , Palmer D. , Bormanis J. 2003 Automated collection of blood components: their storage and transfusion Transfuse Med 13 219 - 225
Sander T. L. , Ou J. S. , Densmore J. C. , Kaul S. , Matus I. , Twigger S. , Halligan B. , Greene A. S. , Pritchard K. A. Jr. , Oldham K. T. 2008 Protein composition of plasminogen activator inhibitor type 1-derived endothelial microparticles Shock 29 504 - 511
Schlossberg H. R. , Herman J. H. 2003 Platelet dosing Transfus Apher Sci 28 221 - 226
Seghatchian J. , Krailadsiri P. 2000 Current position on preparation and quality of leucodepleted platelet concentrates for clinical use Transfus Sci 22 85 - 88
Singh R. P. , Marwaha N. , Malhotra P. , Dash S. 2008 Therapeutic efficacy of different types of platelet concentrates in thrombocytopenic patients Indian J Hematol Blood Transfus 24 16 - 22
Singh R. P. , Marwaha N. , Malhotra P. , Dash S. 2009 Quality assessment of platelet concentrates prepared by platelet rich plasma-platelet concentrate, buffy coat poor-platelet concentrate (BC-PC) and apheresis-PC methods Asian J Transfus Sci 3 86 - 94
Slichter S. J. , Bolgiano D. , Jones M. K. , Christoffel T. , Corson J. , Rose L. , Foley J. , Popovsky M. , Baril L. L. , Corda T. , Dincecco D. M. , Snyder E. L. 2006 Viability and function of 8-day-stored apheresis platelets Transfusion 46 1763 - 1769
Slichter S. J. , Harker L. A. 1976 Preparation and storage of platelet concentrates. II Storage variables influencing platelet viability and function Br J Haematol 34 403 - 419
Svendsen M. S. , Rojkjaer R. , Kristensen A. T. , Salado- Jimena J. A. , Kjalke M. , Johansson P. I. 2007 Impairment of the hemostatic potential of platelets during storage as evaluated by flow cytometry, thrombin generation, and thromboelastography under conditions promoting formation of coated platelets Transfusion 47 2057 - 2065
Tendulkar A. , Rajadhyaksha S. B. 2009 Comparison of plateletpheresis on three continuous flow cell separators Asian J Transfus Sci 3 73 - 77
Tudisco C. , Jett B. W. , Byrne K. , Oblitas J. , Leitman S. F. , Stroncek D. F. 2005 The value of pH as a quality control indicator for apheresis platelets Transfusion 45 773 - 778
Vadhan-Raj S. , Kavanagh J. J. , Freedman R. S. , Folloder J. , Currie L. M. , Bueso-Ramos C. , Verschraegen C. F. , Narvios A. B. , Connor J. , Hoots W. K. , Broemeling L. D. , Lichtiger B. 2002 Safety and efficacy of transfusions of autologous cryopreserved platelets derived from recombinant human thrombopoietin to support chemotherapy- associated severe thrombocytopenia: a randomized cross-over study Lancet 359 2145 - 2152
Van Wijk M. J. , Van Bavel E. , Sturk A. , Nieuwland R. 2003 Microparticles in cardiovascular diseases Cardiovasc Res 59 277 - 287
Wenzel F. , Günther W. , Baertl A. , Gruber A. , Sorg R. V. , Haas R. , Giers G. 2012 Platelet transfusion alters CD40L blood level and release capacity in patients suffering from thrombocytopenia Transfusion 52 1213 - 1220
Yuan S. , Ziman A. , Smeltzer B. , Lu Q. , Goldfinger D. 2010 Moderate and severe adverse events associated with apheresis donations: incidences and risk factors Transfusion 50 478 - 486