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H Kilkson, S Holme and S Murphy
The development of methods for storing platelet concentrates (PCs) at 22
degrees C for transfusion has been predominantly empiric, with minimal
knowledge of metabolic events occurring during storage. It is known that a
decrease in pH due to accelerated production of lactic acid in hypoxic
conditions is a major cause for loss of platelet viability. In the current
studies, we have measured metabolic parameters such as O2 and glucose
consumption rates and CO2 and lactic acid production rates. We have also
determined the O2 and CO2 transport capacities of various containers and
the buffering capacity of plasma. The O2 consumption rate was 1.10 +/- 0.16
(SD) nmol/min/10(9) platelets. In well-oxygenated systems, lactic acid
formation was 1.74 +/- 0.12 nmol/min/mL PC for PCs with a platelet count of
1 to 2 X 10(9)/mL; and 0.52 mol of glucose was consumed per 1 mol lactic
acid produced. In a completely oxygen-free system, lactic acid production
increased 5-8-fold. These calculations suggest that 85% of energy
generation is derived through oxidative metabolism and that glucose may not
be the primary substrate for this metabolism. Bicarbonate concentration,
initially 22.1 +/- 1.6 mEq/L, decreased 1.41 +/- 0.18 nEq/min/mL PC for PCs
with counts 1 to 2 X 10(9) platelets/mL. The loss of bicarbonate was caused
by displacement by lactic acid and as a consequence of spontaneous CO2
efflux from the container. CO2 production, 2.3 +/- 0.4 nmol/min/10(9)
platelets, was derived from oxygen consumption and the CO2 liberated from
bicarbonate as it was consumed. A rapid fall in pH to levels below 7.0 (22
degrees C) took place when the bicarbonate concentration fell below 5 mEq/L
as lactate concentrations reached 20 to 25 mmol/L. A further increase in
lactate concentration from 25 mmol/L to 40 mmol/L correlated with a further
fall in pH to 5.8. Thus, the ultimate storage life of a PC is determined by
continuous lactate production and the fixed buffering capacity of plasma
and by the glucose concentration of the PC. With knowledge of these
parameters, methods for predicting pH as a function of time, platelet
count, and O2 and CO2 transport capability of the container have been
developed as guidelines for future work.
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| Copyright © 1984 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||