Role of acetate during platelet storage in a synthetic medium

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Abstract
It has previously been shown that buffy coat platelet concentrates (BC‐PCs) stored in a medium made up of approximately 70 percent platelet storage medium (Plasma‐Lyte A, PL) and 30 percent plasma (BC‐PC‐P) are effective in vivo after 9 to 12 days of storage. In addition to sodium, potassium, magnesium, and chloride, PL contains 27 m/W (27 mmol/L) sodium acetate and 23 m/W (23 mmol/L) sodium gluconate. This study investigated the effect of acetate and gluconate on platelet metabolism. Identical BC‐PCs were stored at 22 ± 2°C in PL (BC‐PC‐P); PL with gluconate but without acetate, termed PL‐A (BC‐PC‐A); or PL with acetate but without gluconate, termed PL‐G (BC‐PC‐G). On Day 1 of storage, no significant differences were seen between the three groups of BC‐PCs. In both BC‐PC‐P and BC‐PC‐G, pH and bicarbonate were stable at 7.0 ± 0.03 and 8.4 ± 0.9 mEq per L throughout 10 days of storage, whereas in BC‐PC‐A, they fell to 6.7 ± 0.05 and 5.5 ± 0.8 mEq per L on Day 5 (p14C‐ or 3H‐labeled acetate to BC‐PC‐P. On Day 7 of storage, radioactivity decreased to 79 ± 1 percent of baseline in 14C‐labeled BC‐PC‐P (p = 0.02), while it was unchanged in 3H‐labeled BC‐PC‐P and in control samples in which 14C‐ and 3H‐acetate were added to platelet‐free plasma or PL. These studies indicate that platelets metabolize acetate to CO2 during storage and that acetate metabolism plays a major role in pH control during storage of BC‐PCs.