Primary hemostatic capacity of whole blood: a comprehensive analysis of pathogen reduction and refrigeration effects over time.
Author(s): Pidcoke HF, McFaul SJ, Ramasubramanian AK, Parida BK, Mora AG, Fedyk CG, Valdez-Delgado KK, Montgomery RK, Reddoch KM, Rodriguez AC, Aden JK, Jones JA, Bryant RS, Scherer MR, Reddy HL, Goodrich RP, Cap AP
Publication: Transfusion, 2013, Vol. 53 Suppl 1, Page 137S-149S
PubMed ID: 23301966 PubMed Review Paper? No
Purpose of Paper
Conclusion of Paper
Studies
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Study Purpose
The purpose of this study was to determine the effects of storage duration and temperature and PRT-treatment on markers of blood quality. Blood was collected in citrate-phosphate-dextrose (CPD), and half of the specimens were PRT treated in illumination bags by addition of riboflavin and exposure to ultraviolet (UV) light. Specimens were then transferred to storage bags, kept in metal lined storage containers at each temperature, and sampled aseptically.
Summary of Findings:
Lactate increased and glucose and pH decreased with storage, and changes were larger at 22 degrees C compared to at 4 degrees C (p<0.0001, p<0.0001, and p<0.001, respectively). Only the changes in glucose were significantly attenuated by PRT treatment (p<0.008). Hemolysis was unaffected by refrigerated storage but increased during storage at room temperature, especially at day 7 (p=0.014) and beyond. Plt counts decreased with storage at 4 degrees C and PRT treatment. Granulocytes decreased with storage, particularly at room temperature, or with PRT treatment. Clinically irrelevant but statistically significant decreases in white blood cell (WBC) counts were observed during storage, especially in PRT treated specimens. Hct, Hb, RBC counts, D-dimer and soluble CD40 ligand were not significantly affected by storage. PT and aPTT increased with storage duration, but the increase in PT was attenuated by refrigeration, and PT and aPTT were higher in PRT treated specimens than untreated specimens. Agonist stimulated plt aggregation decreased with storage (p<0.001), but the decrease was attenuated by refrigeration. PRT treatment attenuated the storage induced decreases in collagen, thrombin receptor-activating peptide-6, and low ristocetin (RL)-stimulated aggregation compared with untreated specimens (p=0.033) but did not affect adenosine diphosphate (ADP), arachidonic acid agonist (ASPI), and high ristocetin-stimulated aggregation. TEG clotting time (R), clot formation (K), maximum amplitude (MA), clot strength, and total thrombin generation (TTG) were affected by storage at room temperature but remained relatively stable during storage at 4 degrees C. Changes in TEG R, K, alpha angle, and MA during storage were greater in PRT treated specimens then untreated specimens. Fibrinolysis was affected by storage at room temperature, but changes were attenuated by refrigeration (p=0.012) or PRT-treatment (p<0.001).
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Normal
Platform:
Analyte Technology Platform Cell count/volume Hematology/ auto analyzer Cell count/volume Flow cytometry Morphology Hematology/ auto analyzer Protein Hematology/ auto analyzer Protein ELISA Glycoprotein Hematology/ auto analyzer Peptide Hematology/ auto analyzer Carbohydrate Clinical chemistry/auto analyzer Small molecule Clinical chemistry/auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Storage Storage duration 0 days
1 day
2 days
3 days
4 days
5 days
6 days
7 days
14 days
21 days
Storage Storage temperature 4 degrees C
22 degrees C
Storage Storage conditions PRT-treated
Untreated
Hematology/ auto analyzer Specific Reaction solution Collagen
TRAP-6
Low ristocetin
High ristocetin
ADP
Arachidonic acid
Biospecimen Aliquots and Components Blood processing method PRT treated
Untreated
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Study Purpose
The purpose of this study was to determine the effects of storage temperature and PRT-treatment on coagulation markers in plasma. Blood was collected in CPD, and half of the specimens were PRT treated in illumination bags by the addition of riboflavin and exposure to UV light. Specimens were then transferred to storage bags which were stored in metal lined storage containers at each temperature and sampled aseptically.
Summary of Findings:
Factor V, VIII, and protein C in plasma decreased with storage of whole blood (p<0.001). Larger decreases in Factor V and VIII levels were noted in PRT-treated specimens than untreated specimens (p<0.001, both), and larger decreases in protein C and factor VIII were observed with storage of blood at room temperature than 4 degrees C (p<0.001 and p=0.036, respectively). Fibrinogen decreased initially in PRT treated specimens (p<0.001), but storage did not have a significant effect, and all levels were within the normal range. Antithrombin III decreased with storage of blood at room temperature (p<0.001), with insignificantly larger changes noted in PRT treated specimens than untreated specimens. von Willebrand factor levels were not affected by PRT-treatment or storage of blood specimens.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Normal
Platform:
Analyte Technology Platform Protein Hematology/ auto analyzer Glycoprotein Hematology/ auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Storage Storage duration 0 days
7 days
14 days
Storage Storage temperature 4 degrees C
22 degrees C
Storage Storage conditions PRT-treated
Untreated
Biospecimen Aliquots and Components Blood processing method PRT treated
Untreated
Biospecimen Aliquots and Components Centrifugation Centrifugation delays investigated
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Study Purpose
The purpose of this study was to determine the effects of storage temperature and PRT-treatment on plt aggregation and MP counts. Blood was collected CPD, and half of the specimens were PRT treated in illumination bags by the addition of riboflavin and exposure to UV light. Specimens were then transferred to storage bags which were stored in metal lined storage containers at each temperature and sampled aseptically.
Summary of Findings:
Measures of plt aggregation, including percent surface coverage (%SC) and aggregate size (AS), decreased with storage of blood. The decreases were attenuated by refrigeration (p<0.001 and p<0.019) but not PRT-treatment, and %SC and AS remained within the normal range during storage, regardless of conditions. Further, shear-induced plt aggregation (SIPA) and ristocetin-induced plt agglutination (RIPA) were higher after refrigerated storage of blood specimens for 7 days than after room temperature storage (p=0.032 and p=0.002, respectively). The glycoprotein Ib alpha (GPIb) expressing plt population and mean fluorescent intensity of staining decreased with storage, with greater declines noted at room temperature than 4 degrees C (p<0.001 and p=0.004 at day 7, respectively). MP subpopulations tended to increase with storage, but overall increases were insignificant. However, the increases in PRT treated and untreated RBC-MP counts and untreated WBC-MP and tissue factor (TF)-MP counts were significantly greater when blood was stored at room temperature rather than 4 degrees C.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Normal
Platform:
Analyte Technology Platform Cell count/volume Flow cytometry Protein Hematology/ auto analyzer Morphology Hematology/ auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Storage Storage conditions PRT-treated
Untreated
Storage Storage duration 0 days
1 days
2 days
3 days
4 days
5 days
6 days
7 days
10 days
14 days
21 days
Storage Storage temperature 4 degrees C
22 degrees C
Biospecimen Aliquots and Components Blood processing method PRT treated
Untreated