OC 69.3 - The Use of a Microfluidic Model Reveals No Change to Platelet Count or Function After Platelet Transfusion in Traumatic Brain Injury Patients

Tuesday, June 25, 2024

15:15 – 15:30 ICT

Room: 208 A-D

Presenting Author(s)

Jack R. Killinger

Research Technician
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States

Co-Author(s)

Devin Dishong

Research Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
Emily Mihalko

Research Scientist
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
Ronit Kar, BS

Research Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
Amudan Srinivasan

Research Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
LH

Lara Hoteit

Research Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
NA

Nijmeh Alsaadi

Research Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
AA

Abiha Abdullah

Research Fellow
Trauma and Transfusion Medicine Research Center, University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania, United States
RY

Reem Younes

Research Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
MZ

Mohammadreza Zarisfi

Research Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
AA

Aishwarrya Arivudainambi

Research Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
PL

Patricia Loughran

Research Scientist
Center for Biologic Imaging, Department of Cell Biology, University of Pittsburgh Medical Center, Pittsburgh, PA
Pittsburgh, Pennsylvania, United States
DO

David Okonkwo

Professor
Department of Neurological Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
JS

Jason Sperry

Professor
Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
Matthew D. Neal, MD, FACS

Vice Chair of Surgery, Academic Training; Watson Chair and Professor of Surgery
University of Pittsburgh, Pittsburgh, PA, USA
Pittsburgh, Pennsylvania, United States
Susan Shea

Assistant Professor
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States

Background: Patients on antiplatelet medication who develop traumatic brain injuries (TBI) often receive platelet transfusions. Microfluidics simulates physiologic flow conditions and may be valuable for assessing platelet function in these patients.

Aims: We sought to characterize the effect of platelet storage temperature and age on TBI patient platelet function following transfusion.

Methods: Pre- and post-transfusion blood samples were obtained from patients diagnosed with TBI who were on antiplatelet medication and met the need for platelet transfusion (N=25). Platelets were stored at room-temperature (22°C) or in the cold (4°C) for up to 14 days. Platelet storage day at time of transfusion was available for the cold-stored group. Control samples were obtained from healthy volunteers (N=3) and minimally-injured patients without TBI or transfusion (N=3). Samples were incubated with anti-CD41, then perfused through a collagen-coated stenosed microfluidic chamber (initial shear 3500s-1), and imaged with real-time immunofluorescence. Images were analyzed to yield mean fluorescence intensity (MFI), from which fold change and area under the MFI curve over time (AUC) were derived. Groups were compared using ANOVA, t-test, or Tukey’s test.

Results: TBI patients on antiplatelet medication had significant platelet dysfunction compared to healthy and minimally-injured patients. TBI patient platelet function under flow did not recover after platelet transfusion (Fig.1). The effect of transfusion on platelet function was not statistically significant between platelet storage conditions (Fig.2). Platelet function did not statistically differ between cold-stored platelet ages (1-7 days versus >7 days), though there is an apparent trend of older platelets having improved function over younger platelets (Fig.2).

Conclusion(s): Using this novel microfluidic approach to assess platelet function in platelet-transfused TBI patients, we found TBI patients presented with platelet dysfunction and did not differentially respond to platelets stored at different temperatures or of different storage ages. These data indicate the need for nuanced, patient-specific protocols for TBI patients on antiplatelet therapy.