PB1056 - Assessment of the haemostatic potential of platelets readied for transfusion

Tuesday, June 25, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Co-Author(s)

UE

Unwana Emagha

School Pharmacy and Biomolecular Sciences
Royal College of Surgeons in Ireland
Dublin, Dublin, Ireland
KY

Khawla Yousif

School Pharmacy and Biomolecular Sciences
Royal College of Surgeons in Ireland
Dublin, Dublin, Ireland
MD

Michelle Duff

School Pharmacy and Biomolecular Sciences
Royal College of Surgeons in Ireland
Dublin, Dublin, Ireland
EG

Edwina Geraghty

School Pharmacy and Biomolecular Sciences
Royal College of Surgeons in Ireland
Dublin, Dublin, Ireland
JO

Janice O'Shaughnessy

Transfusion laboratory
Beaumont Hospital
Dublin, Dublin, Ireland
PM

Philip Murphy

Haematology Department
Beaumont Hospital
Dublin, Dublin, Ireland
SV

Stefano Verardi

Medical Director
Shionogi Europe
Amsterdam, Noord-Holland, Netherlands
SM

Stephen Marcella

Director, Global Observational Research and Epidemiology- Health Outcomes
Shionogi Inc
Florham Park, New Jersey, United States
RB

Roy Bentley

Executive Director, Global Healthcare Value & Access
Shionogi Inc
Florham Park, New Jersey, United States

Presenting Author(s)

DC

Dermot Cox

Pharmacology Lead
Royal College of Surgeons in Ireland
Dublin, Dublin, Ireland

Background: Based on their clinical presentation, patients may occasionally need platelet transfusions to either prevent or treat bleeding. Platelets are collected and stored in a way that maximises the life span of the platelets once transfused into the recipient. However, there is a paucity of data on the functionality of platelets once transfused.

Aims: In this study, we compared the ex-vivo functionality of residual platelets that were collected from transfusion bags and platelets from healthy donors

Methods: After a platelet unit was transfused into a patient, the platelets remaining in the bag were used to asses platelet function using the Sinnowa PL-12 Aggrestar platelet function analyser (Sinnowa, Nanjing, China). For comparison, platelet function testing was performed in whole blood from healthy volunteers. Aggregation was induced by the addition of ADP, adrenaline (ADR), arachidonic acid (AA) or thrombin receptor activating peptide (TRAP). The primary measurement was maximum aggregation rate (MAR).

Results: The MAR of platelets remaining in the bag after transfusion was 11.7±3.8%, n=38 in response to 5 µM ADP, compared to 63.8±8.6%, n=6 in fresh whole blood (P=0.0001). In contrast the response to thrombin receptor activating peptide was more robust producing a MAR of 76.3±6.8%, n=16 while the response to adrenaline (50 µM) was 12.4±6.8%, n=14. Arachidonic acid produced an intermediate response in stored platelets (36.2±23.7%, n=38) compared with 66.2±18.2%, n=6 in fresh whole blood (P=0.02). Furthermore, platelet response of platelet-rich plasma isolated from fresh blood from healthy volunteers was significantly attenuated in response to ADP.

Conclusion(s): While transfused platelets may restore platelet count there is evidence to suggest that transfused platelets have reduced functionality and thus may not restore haemostatic potential.