1 of 13

THE AIR BUBBLES AND FOAM IN THE BAG OF PLATELET : EFFECTS ON THE QUALITY OF THE FINAL PRODUCT

International Journal of Medical Laboratory 2017;4(3):219-223

Faizul Muslim bin Abd Wahab

Juruteknologi Makmal Perubatan U29

Bahagian Produksi & Pengurusan Bekalan Darah

2 of 13

INTRODUCTION

Platelet transfusion is widely used to prevent hemorrhage in different hematological diseases.

The quality of the platelets can be affected by different factors such as method used for preparation ,storage containers and the transport systems.

Aggregates in platelet units lead to higher activation levels and increased release of immunomodulatory factors.

3 of 13

Objective

The aim of this study was to determine the effects of the air bubbles and foam in the bag of platelet and its effects on the quality of the final product as measured by in vitro parameters after 5 days storage period.

4 of 13

MATERIAL AND METHODS

Platelets were collected from healthy blood donors (450 mL of whole blood)

Stored blood bag at room temperature before processing

(2-6 hours)

Whole blood units centrifuged at 22°C & separation of platelets by platelets rich plasma method (PRP)

5 of 13

10 units to test (presence air bubbles & foam)

10 units to controls (without air bubbles & foam)

stored on flatbed agitator at 22°C

10 mL samples collected from each unit.

Tested for contamination by microbiological culture at day 5

Cellular & metabolic in vitro parameters were evaluated (platelet count, mean platelet volume & pH)

The assessment of swirling was performed by inspection & grading (Bertolini & Murphy)

6 of 13

Platelet aggregation (%) was measured by laboratory aggregometer

Lactate dehydrogenase (LDH) activity (% of total) was assayed spectrophotometrically

Platelet activation markers using a direct standard flow cytometry

The monoclonal antibody used were FITC*CD62P (P-selectin)

The fluorescence of stained platelets was analyzed to obtain the percentage of positively stained cells

7 of 13

RESULTS

Bacterial contamination was not detected in any of the units (test and control platelets on day 5).

Statistically significant differences in a variety of parameters (table 1)

9 of 13

Significant (p-value ≤ 0.05)
Platelets count in the control and test group 1031×10³ and 602×10³ PLTs/μL (p=0.001)
LDH concentration increased in the test units (1037 U/L) and significant higher than control units (322 U/L) on day 5 (p=0.006)

Not significant
pH values were within the established range of PLT products for clinical use.
No significant difference in MPV.
Swirling remained at the highest level (score=2)
The percentage of PLTs expressing the CD62P increased slightly in the test units on day 5 but not significant (p-value =0.408)
Adenosine diphosphate (ADP) on day 5 in the control and test groups was 7.6 and 7.4 but no statistical significance was seen (p-value =0.366).
The mean percentage of aggregation with 150μg/mL ristocetin in the control and test PLTs were 94.30 and 84.90 but not significantly different (p-value =0.407).

10 of 13

DISCUSSION

Significant differences in a variety of parameters between PLTs stored in the presence or absence of air bubbles/foam was found.

Disintegration of PLTs caused by exposure to air bubbles and foam seems to be significantly enhanced.

PLT counts were lower (p=0.001) & LDH was higher (p=0.006) in the test vs control groups. LDH is a potential marker of cell damage.

pH was maintained at ≥6.2 (day 5) and swirling remained at the highest level (score=2) for all units throughout the storage.

The percentage of PLTs expressing the activation marker CD62P showed a slight increase, with not statistical significance (p=0.4).

The presence or absence of air bubbles/foam has no effect on the PLT aggregation.

11 of 13

CONCLUSION

We found that the storage of PLTs in bags containing air bubbles/foam after the 5-day storage period increased disintegration of the PLTs

Due to the low quality of these PLT bags, it is recommended that their use should be avoided, particularly in the patients requiring frequent transfusions of PLTs.

12 of 13

Platelet QC Performance (Jan – Dec 2022)

Indicator

Volume : 60 – 70ml

Platelet Content per Unit : > 60 x 10⁹/unit

Residual Leucocyte : <1 x 10⁶ WBC

pH : > 6.4

Sterility: No bacterial growth

13 of 13