2nd ISTM Annual Conference, TRANSMEDCON 2013, Bangalore

Samantha Kumarage, Joseph Philip, T Chatterjee, Surg Cmdr, R S Mallhi

Armed Forces Medical College, Pune

Introduction: Random donor platelets (RDPs) are prepared almost entirely by the platelet-rich plasma method in North America. RDP is prepared entirely by the Buffy Coat method in Europe. In India, when RDP is prepared by the Buffy Coat method, it is done so, almost entirely, from the whole blood stored at room temperature for less than 8 h as per the DGHS India specifications. Advantages of the Buffy Coat method are less activation of the platelets, recovery of more number of platelets and recovery of more volume of plasma for clinical use.

Aim: Our aim was to evaluate the platelet count, WBC contamination, platelet activation and other biochemical parameters of platelet concentrate prepared from the Buffy Coat within 8 h and within 24 h of collection, respectively, in order to assess and compare the two methods.

Materials and Methods: We prepared 40 units of RDP by the Buffy Coat method from whole blood stored at room temperature within 8 h of collection (fresh BC) and another 40 units from Buffy Coat stored at 22°C for less than 24 h before preparation of RDP(stored BC). We analyzed the platelet counts, platelet activation by CD62P expression by flow cytometry, WBC counts, plasma glucose levels, pH, partial pressure of oxygen and carbon dioxide in both the groups of RDPs 24 h after the respective preparation. IBM SPSS statistical software version 2.1 was used for statistical analysis. P -value less than 0.05 was considered as statistically significant.

Results: The platelet count from stored BC was distinctly higher than that in fresh BC. CD 62P expression was low in stored BC compared with fresh BC, indicating lower platelet activation. There were no differences of pH, pO 2 , pCO 2 and plasma glucose levels in fresh BC and stored BC. WBC contamination was higher in fresh BC compared with stored BC, but it was not statistically significant.

Conclusion: Our study concluded that stored BC contained higher platelet counts, less WBC contamination and less platelet activation. The lesser platelet activation could be due to the fact that on longer keeping, platelet activation would automatically reduce. The higher platelet counts could be because of better mobilization of platelets into the plasma interface because of lesser activation of platelets. WBC contamination will be less due to the increased period of settling. Platelets can be prepared from stored BC during the business hours of the following day. Fewer RDPs are discarded due to low platelet counts as this method recovers comparatively more platelets. Therefore, a less number of units require to be transfused to the patients, which eventually lead to less donor exposure. We conclude that RDP prepared from the Buffy Coat method stored at room temperature for 24 h is the better method for production of RDPs.