Preservation of human platelets with prostaglandin E1 during in vitro simulation of cardiopulmonary bypass.

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Abstract
Platelet abnormalities occurring during cardiopulmonary bypass were produced in vitro by recirculating 500 ml of human blood at 37.degree. C in a silicone rubber circuit (0.9 m2) containing a spiral coil membrane oxygenator. Platelet counts fall to 20% of initial levels, plasma levels of low affinity platelet factor 4 (LA-PF4) rose from 0 to 66% of that in control platelet-rich plasma, and sensitivity to aggregating agents diminished. Inhibition of platelet function with prostaglandin[PG]E1 prevented these changes. In 14 trials (PGE1 = 0.1-10 .mu.M), the thrombocyte count achieved a stable value of 88% within 1 h. Plasma LA-PF4 (PGE1 .gtoreq. 0.3 .mu.M) rose to 10% after 6 h. EM revealed intact platelet granules in recirculated platelets. Platelets incubated and recirculated with PGE1 remained equally sensitive to epinephrine and ADP for 3 h. At 6 h, recirculated platelets in plasma (PGE1 .gtoreq. 0.1 .mu.M) and gel-filtered platelets (PGE1 > 0.3 .mu.M) became significantly less sensitive to epinephrine. At PGE1 .gtoreq. 0.3 .mu.M, gel-filtered recirculated platelets responded normally to epinephrine after 6 h of recirculation. PGE1 preserved platelet levels, prevented contact-initiated release and preserved platelet sensitivity to aggregating agents during in vitro extracorporeal bypass.

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