Comparative analysis of cold-stored apheresis platelet units in additive solution with or without pathogen reduction: Implications of cytochrome c supplementation.

Background: Platelets are limited in supply, and the preservation of platelet function during storage remains challenging. Novel storage approaches are being explored to improve platelet quality, extend shelf life, and reduce risk of infection. This study sought to elucidate platelet function in cold-stored apheresis units in additive solution (platelet additive solution [PAS]) and subjected to pathogen reduction (PR) as well as the impact of cytochrome c (cyt c) supplementation. We hypothesized that the PR would decrease stored platelet function, regardless of cyt c supplementation.

Methods: Platelet apheresis units (PAS) were collected (N = 5 volunteers) and divided into PR or no PR (PAS) and supplemented with vehicle or cyt c (100 μM). Units were stored at 4°C for 15 days, sequential aliquots were removed, and platelet/mitochondrial respiratory function and biochemical parameters were analyzed.

Results: There was no difference in platelet aggregation in response to adenosine diphosphate between PAS and PR platelets. Aggregation function in response to arachidonic acid was higher in PR versus PAS platelets. Maximum clot strength was not different between PAS and PR from Day 0 to Day 5 but declined in PR platelets on Days 10 and 15. Oxygen consumption declined at the same rate in PAS and PR platelets, while rate of lactate and TCO2 decrease was greater in PR platelets than in PAS platelets. Supplementation with cyt c did not alter platelet function or biochemical parameters in PAS or PR platelets.

Conclusion: Platelet additive solution and PR platelets show similar declines in respiratory capacity, and biochemical parameters during cold storage, but PR platelets demonstrated significantly increased arachidonic acid-induced aggregation across all time points. Further understanding this mechanism may provide a means to prolong platelet shelf life.