Removal by adsorbent beads of biological response modifiers released from platelets, accumulated during storage, and potentially associated with platelet transfusion reactions.

摘要

BACKGROUND: Recent studies have demonstrated that biological response modifiers (BRMs) released from platelets (PLTs) during storage may have a clinical significance in PLT transfusion reactions. Washing PLTs and partial substitution of plasma with artificial solutions reduce transfusion reactions, but the washing procedure is time-consuming, and partial plasma substitution is not sufficient to completely eliminate transfusion reactions. STUDY DESIGN AND METHODS: This study determined the levels of three BRMs: soluble CD40 ligand (sCD40L); regulated upon activation, normal T-cell expressed, and secreted (RANTES, CCL5); and transforming growth factor-beta1 (TGF-beta1). These BRMs were released from PLTs during storage up to Day 10. To selectively remove these BRMs, four types of cellulose beads were investigated. The levels of these three BRMs in plasma derived from PLT concentrates (PCs) stored for 10 days or in PCs stored for 5 days were determined after treatment with or without each adsorbent bead for 3 hours. RESULTS: These three BRMs accumulated in proportion to the storage duration. The 3-hour treatment with cellulose beads possessing sulfate ester groups (A) or phosphate ester groups (B) effectively removed sCD40L and RANTES and partly removed TGF-beta1. In addition, although PLT activation was minimally induced, PLT counts decreased by approximately 13% to 30%, after these treatments. CONCLUSIONS: This study revealed that Cellulose Beads A or B are effective in removing the three BRMs that accumulate during PLT storage. Additional in vitro assays and in vivo studies are required to evaluate whether this method is effective in reducing transfusion reactions.