TEG PlateletMapping assay results may be misleading in the presence of cold stored platelets.

Autor: Scorer TG; Centre of Defence Pathology, Royal Centre of Defence Medicine, Birmingham, UK.; School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK.; Coagulation and Blood Research, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA., FitzGibbon L; School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK., Aungraheeta R; School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK., Sharma U; Coagulation and Blood Research, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA., Peltier GC; Coagulation and Blood Research, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA., McIntosh CS; Coagulation and Blood Research, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA., Reddoch-Cardenas KM; Coagulation and Blood Research, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA., Meyer A; Coagulation and Blood Research, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA.; Division of Pediatric Critical Care, Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas, USA., Cap AP; Coagulation and Blood Research, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA., Mumford AD; School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK.
Jazyk: angličtina
Zdroj: Transfusion [Transfusion] 2020 Jun; Vol. 60 Suppl 3, pp. S119-S123. Date of Electronic Publication: 2020 Jun 01.
DOI: 10.1111/trf.15753
Abstrakt: Background: Viscoelastic tests (VETs) are used widely to monitor hemostasis in settings such as cardiac surgery. There has also been renewed interest in cold stored platelets (CSPs) to manage bleeding in this setting. CSPs are reported to have altered hemostatic properties compared to room temperature platelets (RTPs), including activation of GPIIb/IIIa. We investigated whether the functional differences between CSP and RTP affected the performance of the PlateletMapping VET on the TEG 5000 and 6s analyzer.
Method: Platelet concentrates were divided equally into CSP (stored at 4°C ± 2°C) and RTP (stored at 22°C ± 2°C) fractions. Whole blood was treated to induce platelet dysfunction (WBIPD) by incubating with anti-platelet drugs (1.0 μM ticagrelor and 10 μM aspirin) or by simulating cardiopulmonary bypass. WBIPD samples were then mixed with 20% by volume of CSPs or RTPs to model platelet transfusion before analysis using the PlateletMapping VET.
Results: Addition of CSPs to WBIPD increased the PlateletMapping MA FIBRIN and MA ADP parameters with the TEG 5000 analyzer (both p < 0.0001 compared to addition of buffer alone). This effect was not observed with RTPs. The differential effect of CSPs on the MA FIBRIN corrected after pre-incubation with the GPIIb/IIIa antagonist tirofiban and was quantitatively less with the PlateletMapping test for the TEG 6s analyzer which contains the GPIIb/IIa antagonist abciximab.
Discussion: The PlateletMapping MA FIBRIN and MA ADP test results may be misleadingly high with CSPs, particularly with the TEG 5000 analyzer, most likely due to constitutive activation of GPIIb/IIIa on CSPs during storage. TEG PlateletMapping results should be interpreted with caution following CSP transfusion.
(© 2020 Crown copyright.Transfusion © 2020 AABB.)
Databáze: MEDLINE
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