Publication Date:
2010-11-19
Description:
Abstract 3360 Background- Apheresed platelet concentrates accumulate biologic response modulators (BRMs) with prolonged storage. BRMs have been localized to the supernatant fraction of stored blood products and BRM levels correlate with length of storage. BRMs, and hence transfusion, have been demonstrated to function as a recipient immune “second hits”, in the construct of the two hit model of multiple organ dysfunction and failure. Furthermore, contemporary practices for apheresed platelet processing and storage restricts transfusibility to five days or less from time of collection. Platelet processing by lyophilization offers the potential for long term platelet storage and transfusibility. Lyophilized platelets (LP) are preserved in a metabolically inactive state until rehydrated in sterile water immediately prior to infusion and therefore, intuitively, of limited BRM activity. We hypothesized that LP transfusion will not constitute an immunologic “second hit”. Methods- Rhesus Macaques were anesthetized and subjected to grade III hemorrhagic shock to induce a systemic inflammatory profile consistent with an immunological “first hit”. To determine the “second hit” capability of LP, 2 × 1010 reconstituted LP (a weight based equivalent dose of an average size human receiving 1 six pack of platelets) were infused at 15 minutes (T=15) following the initiation of shock. In parallel experiments, normal saline (NS) or 2 × 1010 fresh (day 1 – 3) apheresed human platelets (FAP) were infused at T=15 15 minutes following initiation of shock to serve as controls. Subsequently, volume resuscitation with additional normal saline, per ATLS guidelines, was performed and all animals survived for 480 minutes (T=480) post-shock initiation. Physiologic parameters were continually monitored, serum collected immediately preceding shock (T=0), T=240 and T=480 for TNF α, IL-1β, IL-6, and IL-8 analysis. Supernatants from the LP and FAP administered during the study were assayed for pro-inflammatory cytokines. All cytokine detection was performed on a Luminex IS 100. Analysis: paired sample t-test and one-way ANOVA; results reported as mean (SEM). Results- Grade III hemorrhagic shock, determined by a reduction in MAP (43% (4.5), p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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