Comparison of Fresh, Liquid-Preserved, and Cryopreserved Platelets: Changes in Thromboxane A2 Production, Adhesive Surface Receptors, and Membrane Procoaulant Activity

摘要

Previous studies have determined that compared to 3-4 day 22 deg C liquid-preserved platelets, transfusion of cryopreserved platelets results in improved hemostatic function despite decreased survival in the setting of cardiopulmonary bypass. We studied fresh, 2-4 day stored liquid-preserved platelets, and cryopreserved platelets using monoclonal antibodies directed against platelet surface CD62P, glycoprotein (GP) Ib, activated GPIIb-IIIa complex, and surface-bound coagulation factor V by a 3 color flow cytometric method. Platelet production of thromboxane B2 (TXB2) was measured by RIA after aggregation with a combination of arachidonic acid and ADP. Whereas the production of TXB2 by liquid-preserved platelets after stimulation with ADP/ arachadonic acid combination was significantly lower (161 +/- 224 pg x 10(exp - 6)/platelet) than fresh platelets (346 +/- 202, p = 0.02), the production of TXB2 by cryopreserved platelets after stimulation was significantly higher (589 +/- 341) than fresh platelets (353 +/- 215 p = 0.02). Compared to fresh or liquid-preserved platelets which had >97% normal surface levels of GPIb, cryopreserved platelets were composed of distinct subpopulations of 51.4% GPIb- normal and 48.6 +/- 9.1% (mean +/- SD) GPIb-reduced platelets. Both populations exhibited a significantly increased percentage of procoagulant platelet-derived microparticles compared to fresh or liquid-preserved platelets, based on decreased forward light scattering and bound factor V (12.3 +/- 7.5% of the GPIb-normal and 95.3 +/- 1.9% of the GPIb-reduced, p<0.02 compared to fresh 04 +/- 0.2%). Total binding of factor V was also elevated in the post-thaw-washed cryopreserved platelet product compared to either fresh or day 314 liquid- preserved platelets with the GPIb-reduced population accounting for the majority of this activity.