Liquid storage of thrombocytes: in vivo survival capability of thrombocytes after storage at +12 degrees C

Platelet concentrates were prepared from ACD-blood and stored at +12 degrees C for 3 days with gentle agitation. The viability of the platelets was estimated by autologous transfusion of 51chromium-labeled platelets into healthy volunteers. The in vivo recovery amounted to 33.5 +/- 6.9% and mean half survival time T0,5 was 1.1 ++/- 0.2 days on the 3rd day. The control values for freshly prepared platelet concentrates were 52.5 +/- 5.9% and T0.5 3.9 +/- 0.3 days. The decrease of viability due to lowering the temperature to +12 degrees C did not correspond to the pH-value, which was well maintained in the stored platelets.     

Fluid storage of thrombocytes. In vitro viability of thrombocytes at 12 degrees C storage temperature

Platelet concentrates from ACD-blood were stored with and without agitation at +12 degrees C for 3 days. pH-values, hypotonic shock response, serotonin uptake and adenine nucleotides were investigated. In addition platelet shape was morphologically differentiated in discs with and without pseudopods, in spheres and irregular platelets. In accordance with platelet storage at +22 degrees C an optimum platelet number and gentle agitation were essential to maintain in vitro vitality at +12 degrees C for 3 days. The number of discoid platelets declined from 76% in fresh platelet concentrates to 25% after 3 days at +12 degrees C although pH-values did not fall below 6.8 in the agitated concentrates. A diminished post-transfusion survival could result from this, unless the shape change reverses in the circulation.     

Cryopreservation of dog platelets with dimethyl sulfoxide: therapeutic effectiveness of cryopreserved platelets in the treatment of thrombocytopenic dogs, and the effect of platelet storage at -80 degrees C

Dog platelets were frozen with 6% dimethyl sulfoxide at 2-3 degrees C per minute in a -80 degrees C mechanical freezer. The frozen platelets were stored at -80 degrees C for as long as 39 months. After storage at -80 degrees C for less than 1 year, platelet in vitro freeze-thaw-wash recovery values were 70%, and in vivo survival values 1 to 2 hr after transfusion were 40% those of fresh platelets. After 2 years or longer storage, in vitro freeze-thaw-wash recovery values were 60%, and in vivo survival values 1 to 2 hr after transfusion were 20% those of fresh platelets. These results indicate that significant deterioration of the dog platelets occurred between the first and second year of storage at -80 degrees C. Platelets that were stored frozen at -80 degrees C for less than 1 year and washed before transfusion into lethally irradiated thrombocytopenic dogs were hemostatically effective.     

Survival of bovine embryos stored at 4 degrees C

These experiments were designed to test the efficacy of storing bovine embryos at 4 degrees C. Of particular interest were the age of embryo at which maximum post-storage survival could be achieved and longevity at 4 degrees C. A greater proportion of day 8 blastocysts developed in vitro at 37 degrees C following refrigeration for 48 hr than did embryos collected 2, 4 or 6 days after estrus (P<0.01). Survival of blastocysts stored at 4 degrees C for 48 hr was similar to that of nonstored blastocysts. In a subsequent experiment, day 8 blastocysts were recovered nonsurgically and assigned to one of the following treatments: (a) immediate transfer; (b) culture at 37 degrees C; or (c) storage at 4 degrees C for 1, 2, 3 or 5 days. Post-storage viability was assessed by either development in culture at 37 degrees C or embryo survival following nonsurgical transfer to synchronized recipients. In vitro survival of nonstored embryos and embryos stored 1 day did not differ. Survival decreased after storage for 2 days (P<0.10) or longer (P<0.05). Similar results were observed for survival after transfer, but embryo viability decreased even more rapidly with increasing duration of storage. In vitro survival was approximately 50% for blastocysts stored for 3 and 5 days, but few pregnancies resulted from transfer of embryos stored for these periods. In another experiment survival after transfer of blastocysts stored at 4 degrees C for up to 2 days was similar to that of nonstored blastocysts.     

Comparative study on the percentage of recovery, survival and mode of sequestration of fresh and frozen preserved (-196 degrees C) human platelets

Platelet concentrates amounting to 142 X 10(9) +/- 11 X 10(9) cells are prepared by cytopheresis from one liter of blood. Ten of the concentrates are labelled with 51Cr and reinfused autologously. The other ten concentrates are frozen with a controlled rate freezer in a medium containing 10% DMSO and 5% glucose for 7 days at -196 degrees C. The fresh platelets have a 51Cr 24 hrs. recovery of 68 +/- 7% and a survival rate (T 1/2) of 10 +/- 1 days. The frozen preserved platelets have a 51Cr 24 hrs. recovery of 54 +/- 6.1%, a T 1/2 of 8.1 days, and significantly increased liver sequestration. There is a correlation between the reversal reaction in vitro after hypotonic shock and the 51Cr 24 hrs. in vivo recovery of fresh platelets and the 51Cr 1st hr. recovery of frozen platelets.     

State and development of liquid conservation of thrombocytes]

In the present investigation the storage effect of AcD-AG and CPD-AG-stabilizers on thrombocytes was tested. The platelets were stored in platelet-rich plasma (PRP) at 4 degrees C or room temperature for 3 days. The concentrates gained by it were marked with Na251CrO4 and reinjected. The thrombocytokinetic parameters were evaluated. The results show that storage with the help of the mentioned stabilizers can be made to a certain extent only. Platelets stored in AcD-AG stabilizerhad a survival time of 2.7 +/- 1.1 days towards 9.0 +/- 1.0 days of fresh whole blood concentrates. The survival time of CPD-AG thrombocytes stored at 4 degrees C for 3 days amounted to 2.0 +/- 0.5 days. Storage of CPD-AG platelets at room temperature showed favourable results. Their survival time amounted to 6.2 +/- 0.6 days. Measurements of surface activity above the spleen and the liver indicate that degradation of stored platelets is mainly performed in the spleen. Problems of liquids storing in view of the significance of therapeutic thrombocyte substitution for hospitals are referred to.     

Effect of phospholipase C (Bacillus cereus) on freshly isolated and 4-day-stored human platelets.

Phospholipase C (from Bacillus cereus) was used to study fresh and stored human platelets. Provided that the enzyme was inactivated before lipid extraction, no significant degradation of phospholipid in fresh cells was noted, even when platelets were activated or induced to change shape by ADP, collagen or thrombin. With platelets isolated from concentrates stored for transfusion for 4 days at 22 degrees C, membrane phospholipids were degraded by the enzyme to an extent depending on the pH in the platelet concentrate at day 4 of storage. The extent of phospholipid hydrolysis in platelets correlated well with the extent of release of lactate dehydrogenase during storage, with both being minimal for platelets from concentrates of final pH 6.5-6.9. Under non-lytic conditions, phosphatidylcholine was the phospholipid most degraded (40%), with no significant degradation of phosphatidylserine being detected. Storage does not seem to alter the distribution of phospholipids at the external leaflet of the plasma membrane.     

Development of optimal techniques for cryopreservation of human platelets. I. Platelet activation during cold storage (at 22 and 8 degrees C) and cryopreservation.

Using the current blood bank storage conditions at 22 degrees C, the viability and function of human platelets can be maintained for only 5 days. This does not allow for the necessary and extensive banking of platelets needed to treat patients afflicted with thrombocytopenia, a side effect of many invasive surgeries such as cardiopulmonary bypass or bone marrow transplantation. The development of optimal techniques for long-term cryopreservation and banking of human platelets would provide the ability to greatly extend the viable life of the platelet and would fulfill an increasing and urgent need in many clinical applications. To determine the optimal techniques for platelet preservation, the expression of an activation marker, phosphatidylserine, on the platelet membrane during storage at 22 and 8 degrees C as well as during the different freezing preservation processes was examined using flow cytometry and annexin V binding assay. Human platelets were identified by both CD41 and light scatter in flow cytometry. In cryopreservation experiments, effects of the following factors on platelet activation were evaluated: (a) cryoprotective agents (CPAs) type: dimethyl sulfoxide (Me2SO), ethylene glycol (EG), and propylene glycol (PG), (b) CPA concentration ranging from 0 to 3 M, and (c) ending temperatures of a slow cooling process at -1 degrees C/min. Our results demonstrated that (a) approximately 50% of platelets were activated on days 7 and 16 at 22 and 8 degrees C, respectively; (b) platelets were not significantly activated after 30-min exposure to 1 M Me2SO, EG, and PG at 22 degrees C, respectively, and (c) there was a significant difference in cryoprotective efficacy among these three CPAs in preventing platelets from cryoinjury. After being cooled to -10 degrees C, 74% of the cryopreserved platelets survived (nonactivated) in 1 M Me2SO solution, while in 1 M EG and 1 M PG solutions, 62 and 42% of the platelets survived, respectively. Using the information that Me2SO consistently yields higher percentages of nonactivated platelets and does not seem to be cytotoxic to platelets for 30-min exposure time, this was found to be the optimal cryoprotective agent for platelets. In addition, significant Me2SO toxicity to platelets was not noted until Me2SO concentrations exceeded 2 M. Finally, a concentration of 1 M Me2SO proved to be the most effective at all cryopreservation ending temperatures tested (-10, -30, -60, and -196 degrees C). In conclusion, under the present experimental conditions, a storage temperature of 8 degrees C appeared to be much better than 22 degrees C. Although the potential chemical toxicity of 1 M Me2SO, EG, or PG is negligible, 1 M Me2SO was found to be optimum for cryopreservation of human platelets. PG has the least cryoprotective function for low-temperature platelet survival.     

Fertilizing capacity of equine spermatozoa stored for 24 hours at 5 or 20 degrees C

A breeding trial was conducted to evaluate the effect of in vitro storage time and temperature on fertilizing capacity of equine spermatozoa. Semen obtained from one stallion and diluted with skim milk-glucose extender was used to artificially inseminate 45 estrussynchronized mares. The mares were assigned to one of three treatment groups (15 mares per group): 1) insemination with fresh semen (collected within 0.5 h of use), 2) insemination with semen stored for 24 h at 20 degrees C or 3) insemination with semen stored for 24 h at 5 degrees C. The mares were inseminated daily during estrus, from the detection of a 35-mm follicle until ovulation, with 250 x 10(6) progressively motile spermatozoa (based on initial sperm motility of fresh semen). Semen samples (n = 35) were evaluated prior to insemination for percentages of total sperm motility (TSM), progressive sperm motility (PSM) and sperm velocity (SV). Single-cycle 15-d pregnancy rates. resulting from insemination with fresh semen, from fresh semen stored for 24 h at 20 degrees C or from semen stored for 24 h at 5 degrees C were the same (11 15 ; 73%). Mean diameters (mm) of 15-d embryonic vesicles were not different (P>0.05) among these three treatment groups (21.5 +/- 2.9, 19.6 +/- 2.6 and 20.5 +/- 3.6, respectively). Ten pregnant mares were aborted on Day 15 of gestation for use in another project. The pregnancy status of the 23 remaining pregnant mares was again determined at 35 to 40 d and 55 to 60 d of gestation. No pregnancy losses occurred during this time period. Mean TSM percentages were different (P<0.05) among the three groups: the fresh semen percentage was 89 +/- 2, semen stored for 24 h at 20 degrees C was 57 +/- 11 and semen stored for 24 h at 5 degrees C was 80 +/- 6. Similar differences were found for mean PSM and SV. Semen storage at either 20 or 5 degrees C for 24 h had no apparent effect on the fertilizing capacity of the extended semen samples; however, the reduction in all motility parameters tested was more dramatic in semen stored at 20 degrees C than that stored at 5 degrees C.     

Reversible effects of glycerol on the metabolism of platelets kept at room temperature

The effects of the addition and removal of glycerol on the metabolic activities of human platelets were studied. Platelet concentrates (PC) with 20 ml plasma were stored with 3-7% (v/w) glycerol in 150-ml polyvinylchloride plastic bags for 2 days at 22 degrees C with constant agitation. Incubation of glycerol with platelets produced a dose-dependent inhibition of oxygen consumption. The inhibitions of glucose utilization and lactate production had reached the plateau level at 3% glycerol. The rate of adenosine triphosphate (ATP) generation of control platelets was 9.8 nmol/min/10(9) platelets, in which over 90% ATP generation was derived from oxidative phosphorylation. There was a dose-dependent decrease (up to 20%) by glycerol in the rate of platelet ATP generation. Glycerol inhibited glycolysis more than oxidative phosphorylation. However, the inhibition potency diminished with increasing concentrations of glycerol. The energy metabolism of platelets after removal of 5% glycerol was examined. Deglycerolized platelets after 1 hr incubation facilitated energy metabolism more strongly than that of 24 hr incubation. The platelet aggregation response to collagen was not impaired by a cycle of the addition and removal of glycerol. The results indicate that glycerol lowered the rate of ATP generation of platelets stored at 22 degrees C. However, the removal of glycerol reversed the decreased energy metabolism.     

The use of inhibitors of platelet activation or protease activity in platelet concentrates stored for transfusion.

During storage of platelet concentrates the platelets show signs of activation, and extracellular protease activity becomes evident in the plasma. The consequences of platelet activation and plasma protease activity are potentially detrimental to the preservation of platelet function in vitro. The earlier use of prostaglandins during preparation of platelet concentrates to increase the harvest of platelets from whole blood did little to improve their shelf-life. Other compounds that sustain elevated cyclic AMP levels or that directly inhibit platelet agonists provide more effective inhibition of platelet activation during storage. Also, the inclusion of general or specific protease inhibitors appears to improve platelet preservation over extended storage periods. These studies demonstrate the possibility of prolonging the shelf-life of platelet concentrates stored at 22 degrees C through the addition of non-toxic formulations of inhibitors of platelet activation and protease activity.     

The effect of the AcD-AG stabilizer on the survival time and surface properties of fluid preserved platelet concentrates compared to concentrates from fresh blood]

In the present investigations the storage effect the AcD-AG stabilizer on thrombocytes is examined. The thrombocytokinetic parameters of 9 fresh blood concentrates and 15 concentrates of AcD-AG plasma containing platelets were determined. Storage time amounted to three days. The results show that storage with AcD-AG is only possible to a limited degree. On an average the survival time of the platelets was reduced to 2.7 +/- 1.1 days compared with 9.0 +/- 1.0 days of fresh blood concentrates. The recovery of the stored platelets amounted to 25.3 +/- 16.1%, that of the fresh blood concentrates to 63.3 +/- 23.6%. The spleen-heart quotients and those of the liver-heart or the surplus impulses over the spleen and liver respectively indicate that there is a predominant destruction in the spleen for those thrombocytes stored for three days. The liver is scarcely involved in this sequestration process. With 36.1% platelet yield was very low in concentrates gained from AcD-AG plasma containing platelets and having been stored for 3 days. In cases of emergency a clinical application of concentrates prepared in this way should not be given up. If being used, the greater requirement has to be taken into account. If the substitution therapy is continued, however, fresh blood concentrates have to be used as soon as possible.     

Relationship between dead cells and DNA fragmentation in bovine embryos produced in vitro and stored at 4 degrees C.

DNA fragmentation and its relationship with dead cells were examined in bovine blastocysts produced in vitro and stored at 4 degrees C for 1-5 days. Survival and development to the hatching and hatched blastocyst stage decreased with increasing storage time. Both were significantly lower at 72 hr than at 48 hr. None of the embryos stored for 120 hr developed to the hatching or hatched blastocyst stage. The proportion of dead cells per embryo increased progressively as the time of storage increased, until 69% of embryonic cells were dead after 120 hr of storage. There was no significant difference between the proportions of DNA fragmentation per embryo stored for 0 and 24 hr (12% vs 16%). However, the proportion of DNA fragmentation in embryos stored for longer than 48 hr was significantly greater than that in embryos stored for less than 24 hr. There were no significant differences among those stored for longer than 48 hr (28-33%). These results suggest that the reduced developmental competence of bovine embryos stored at 4 degrees C is characterized by necrotic change rather than apoptotic change.     

Dipeptidyl-amino-peptidase IV activity in stored buffy coat smears from human blood

The stability of dipeptidyl-amino-peptidase IV (DAP IV) activity in lymphoid cells of buffy coat smears from human blood was studied during storage for 40 days. Fixed or unfixed smears may be stored at 20 C for up to 24 hr before a decrease in activity occurs. Storage of either fixed or unfixed smears at 4 C, -10 C and -80 C results in a significant loss of activity within 24 hr. However, the cells retain more than 85% of their DAP IV activity for up to 10 days when stored fixed at -80 C. These data underscore the importance of proper processing of slides for DAP IV staining to avoid misinterpretation of results.     

Contribution of perfusion techniques to the evaluation of the hemostatic effectiveness of platelet concentrates.

Perfusion systems allowing the morphometric analysis of platelet interactions with vessel subendothelium under flow conditions have been applied to evaluate the quality and function of stored platelets. Studies performed in vitro indicate that despite the existence of storage lesions, platelets in concentrates stored for up to 5 days retain their ability to interact with the subendothelium. Perfusion studies ex vivo with nonanticoagulated blood from anemic-thrombocytopenic patients have shown the critical hemorrheological role of red blood cells facilitating platelet interactions with subendothelium. Similar studies performed on severely thrombocytopenic patients who received transfusions of platelets stored at 4 degrees C indicate that incompletely viable platelets can contribute to primary hemostasis through procoagulant mechanisms. The latter results suggest that storage lesions which contribute to impairment of platelet function may result in enhancement of platelet procoagulant activities. Perfusion techniques have contributed to the evaluation of the hemostatic effectiveness of platelet concentrates. These techniques will provide a useful model to test the impact of new storage technologies on platelet hemostatic function.     

Preparation and Pathogen Inactivation of Double Dose Buffy Coat Platelet Products using the INTERCEPT Blood System

Blood centers are faced with many challenges including maximizing production yield from the blood product donations they receive as well as ensuring the highest possible level of safety for transfusion patients, including protection from transfusion transmitted diseases. This must be accomplished in a fiscally responsible manner which minimizes operating expenses including consumables, equipment, waste, and personnel costs, among others.Several methods are available to produce platelet concentrates for transfusion. One of the most common is the buffy coat method in which a single therapeutic platelet unit (≥ 2.0 x10¹¹ platelets per unit or per local regulations) is prepared by pooling the buffy coat layer from up to six whole blood donations. A procedure for producing "double dose" whole blood derived platelets has only recently been developed.Presented here is a novel method for preparing double dose whole blood derived platelet concentrates from pools of 7 buffy coats and subsequently treating the double dose units with the INTERCEPT Blood System for pathogen inactivation. INTERCEPT was developed to inactivate viruses, bacteria, parasites, and contaminating donor white cells which may be present in donated blood. Pairing INTERCEPT with the double dose buffy coat method by utilizing the INTERCEPT Processing Set with Dual Storage Containers (the "DS set"), allows blood centers to treat each of their double dose units in a single pathogen inactivation processing set, thereby maximizing patient safety while minimizing costs. The double dose buffy coat method requires fewer buffy coats and reduces the use of consumables by up to 50% (e.g. pooling sets, filter sets, platelet additive solution, and sterile connection wafers) compared to preparation and treatment of single dose buffy coat platelet units. Other cost savings include less waste, less equipment maintenance, lower power requirements, reduced personnel time, and lower collection cost compared to the apheresis technique.     

Computerization of a bank of platelets with HLA phenotype and preserved at -196 degrees C

In order to complete the logistics of the unit cytapheresis, we have developed a decision helping system which rests upon the computer management of -196 degrees C cryopreserved HLA type platelets. The hardware used is a micro-computer equipped with two floppy disks and a printer. Two files have been created: namely "Product" and "Patient". Data relating to 800 platelet concentrates may be recorded on a floppy disk. The software which has been developed has several functions: 1 - The input of the parameters of a HLA type concentrate with the possibility of reservation for the given recipient; 2 - The print out of the bank's stock; 3 - The selection and the reservation of HLA matched platelets according to the recipient; 4 - The print out of concentrates allocated to each patient, it is possible to thaw out chosen platelet concentrate and a thawing report is printed out, thus enabling one to locate the concentrate in the bank. Thanks to this "aid in decision making", the management of - 196 degrees C cryopreserved HLA type platelets may be carried out. The proposed software allows an one line answer for any emergency transfusion case. Considering the recipient HLA typing the suitable best match platelet concentrates are instantly transfused or save.     

Comparison of posttransfusion recoveries achieved with either fresh or stored platelet concentrates

The effectiveness of platelet concentrate transfusion depends on such variables as blood bag material, donor--recipient compatibility, and time elapsed between donation and transfusion. To study the latter a corrected thrombocyte increment for recovery in the recipients was evaluated with 108 platelet transfusions in 31 patients. In 83 treatment programs, the mean recovery at the one-hour post-transfusion time point was 8.6 X 10(9) platelets/l with fresh platelets and 5.9 X 10(9) platelets/l with stored platelets. Significantly better recovery was achieved with freshly prepared platelet over the total of platelet concentrates stored for up to 96 hours; however, if the recoveries in different patient groups given stored platelets were considered separately in terms of storage times of up to 48 h or 48-96 h, the good recovery with fresh platelets was significantly better only when compared to the older (p = 0.034) but not to the younger group of stored platelets. In patients with signs indicating enhanced platelet destruction (fever, splenomegaly, disseminated intravascular coagulation) the transfusion with fresh platelet concentrates gave a significantly better recovery compared to stored platelet concentrates (p = 0.028), whereas in the absence of such signs the recovery produced by fresh concentrates was not significantly higher than with stored concentrates. These findings may be relevant for the logistics in blood banking.     

A note on the survival of bacteria in cryoprotectant medium at temperatures above 0 degrees C

Many bacteria can survive for days or weeks at temperatures of 4 degrees or 22 degrees C in medium containing 15% (v/v) glycerol as a cryoprotectant. This observation suggests that breakdown of refrigeration for a short time may not be a serious danger to survival of cultures stored frozen in such media.     

Comparison between in vitro lipid peroxidation in fresh sheep platelets and peroxidative processes during sheep platelet ageing under storage at 4 degrees C.

Incubation of sheep platelet crude membranes with xanthine oxidase (XO)/hypoxanthine/Fe(2+)-ADP revealed: (i) a fast peroxidative response - with a maximal linear rate of 14 nmol malondialdehyde (MDA) equivalents/mg protein, as evidenced by the thiobarbituric acid test - and a decrease in the polyunsaturated fatty acid (PUFA) content of the platelet crude membranes; (ii) a decrease in the lipid fluidity in the deep lipid core of the membranes but not at the membrane surface; (iii) a dramatic inhibitory effect on glucose 6-phosphatase (Glc-6-Pase) but not on acetylcholinesterase activity. Platelets were also aged by storage at 4 degrees C in their own plasma or in Seto additive solution. In these media, platelet aggregates were visible and the effects on platelet phospholipids, PUFA, lipid extract fluorescence, crude membrane fluidity and membrane-bound enzyme activities were assessed for comparison with those observed in in vitro lipid peroxidation. The sensitivity of membranes from stored platelets to lipid peroxidation was also assessed. Storage of platelets in plasma for 5 days was associated with different changes in their crude membranes such as decreases in arachidonic acid contents, the decrease not being avoided by the presence of phospholipase A(2) inhibitors, increases in MDA equivalents, conjugated dienes and lipid extract fluorescence, decreases in the amounts of MDA equivalents formed by platelet crude membranes treated with the oxidizing agents, changes in membrane fluidity and inhibition of Glc-6-Pase. All these alterations were less pronounced or even abolished after platelet storage in Seto. These findings suggest that platelet lipid peroxidation due to XO/hypoxanthine/Fe(2+)-ADP and platelet membrane alterations observed after platelet ageing under storage at 4 degrees C share common features. Also, as regards the prevention of peroxidative processes, Seto solution permits better storage of sheep platelets than plasma.