Evaluation of a new citrate‐acetate‐NaCl platelet additive solution for the storage of white cell‐reduced platelet concentrates obtained from half‐strength CPD pooled buffy coats

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Abstract
BACKGROUND: A new citrate‐acetate‐NaCl platelet additive solution, identified as PAS 2, was developed to prepare platelet concentrates (PCs) from pooled 0.5 CPD buffy coats (BCs). STUDY DESIGN AND METHODS: A study was undertaken to evaluate PAS 2 in vitro (n = 8) and in vivo (n = 9) against a commercially available solution (Plasma‐Lyte A). In a paired in vitro study, a comparison was made of platelet and white cell concentration; blood gases and bicarbonate; glucose and lactate concentration; total intracellular concentration of adenine nucleotides and beta‐thromboglobulin release. RESULTS: A lower platelet yield (p < 0.0001) and a higher beta‐thromboglobulin release (p < 0.01) are observed with Plasma‐Lyte A. For this reason, half‐strength (0.5) CPD was changed to full‐strength CPD in the clinical study with Plasma‐Lyte A. In a clinical evaluation of nine patients with bone marrow failure, all received PCs with both PAS 2 and Plasma‐Lyte A that had a shelf life of at least 4 days. Corrected count increments (CCls) were as follows, on average (95% Cl): the CCl at 1 to 4 hours was 22.4 (95% Cl, 15.2‐29.4) for PAS 2 and 24.0 (95% Cl, 16.9‐31.2) for Plasma‐Lyte A; that at 12 to 24 hours was 11.3 (95% Cl, 4.1‐18.4) for PAS 2 and 14.2 (95% Cl, 7.1‐21.3) for Plasma‐Lyte A; and that at 36 to 48 hours was 4.2 (95% Cl, ‐3.0‐11.3) for PAS 2 and 8.7 (95% Cl, 1.1‐16.2) for Plasma‐ Lyte A. No significant difference between the two solutions was found. CONCLUSIONS: PAS 2 and Plasma‐Lyte A make important contributions to platelet transfusion quality improvement and give an excellent CCl even after 4 days of storage.