Impaired Platelet Function among Platelet Donors

Petra Jilma-Stohlawetz; Nicole Hergovich; Monika Homoncik; Larisa Dzirlo; Michaela Horvath; Michael Janisiw; Simon Panzer; Bernd Jilma

doi:10.1055/s-0037-1616146

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2001; 86(03): 880-886
DOI: 10.1055/s-0037-1616146

Review Articles

Schattauer GmbH

Impaired Platelet Function among Platelet Donors

Petra Jilma-Stohlawetz

²Department of Blood Group Serology and Transfusion Medicine, Division of Transfusion Medicine, Vienna University, Vienna, Austria

,

Nicole Hergovich

¹Departments of Clinical Pharmacology-TARGET

,

Monika Homoncik

¹Departments of Clinical Pharmacology-TARGET

,

Larisa Dzirlo

¹Departments of Clinical Pharmacology-TARGET

,

Michaela Horvath

²Department of Blood Group Serology and Transfusion Medicine, Division of Transfusion Medicine, Vienna University, Vienna, Austria

,

Michael Janisiw

²Department of Blood Group Serology and Transfusion Medicine, Division of Transfusion Medicine, Vienna University, Vienna, Austria

,

Simon Panzer

²Department of Blood Group Serology and Transfusion Medicine, Division of Transfusion Medicine, Vienna University, Vienna, Austria

,

Bernd Jilma

¹Departments of Clinical Pharmacology-TARGET

› Author Affiliations

Abstract

Summary

Background: Platelet transfusions are effective for the prevention and treatment of bleeding in patients with disorders of platelet number and/or function. In recent years plateletpheresis concentrates have outnumbered pooled platelet concentrates, albeit with significant differences between nations. Thus, the platelet quality of individual donors has become increasingly important. The aim of this study was to gain an estimate for the prevalence of impaired platelet function among platelet donors. Study design and methods: We determined the inter-donor variability in platelet plug formation with a PFA-100 analyzer, the prevalence of impaired thromboxane formation, and effects of the density in alpha2 integrin polymorphism and density. Results: (i) Collagen-epinephrine induced closure time (CEPI-CT) showed a great inter-subject variability in platelet donors and was higher than in healthy controls (p = 0.008). One-fifth of donors had abnormal CEPI-CT values and 11% exceeded >300 s (max measurable value). (ii) Decreased serum thromboxane B₂ levels were found in 9% of all donors, compatible with surreptitious intake of cyclooxygenase inhibitors or with an aspirin-like defect. CEPI-CT correlated inversely with TxB₂-levels in donors and controls. (iii) The density of the alpha_2-integrin correlated negatively with CEPI-CT and CADP-CT values in controls, but was not responsible for the observed impaired platelet function in donors. (iv) Finally, the ABO blood group system modulates closure times. Conclusion: In sum, a large number of platelet donors present with prolonged closure times. Decreased thromboxane formation and frequent platelet donation partly account for this observation.

Abbreviations: 807 CC/CT/TT polymorphisms of the alpha2-integrin gene, CD36… GPIIIb, an alternative collagen receptor, CD42b… GpIb, the von Willebrand receptor, CD49b… alpha2-integrin, subunit of the main collagen receptor, CADP-CT… collagen adenosine diphosphate induced closure time, CEPI-CT… collagen/epinephrine induced closure time, PFA-100… platelet function analyzer, vWF-Ag… von Willebrand factor antigen, TXB2… thromboxane B2

Key words

Platelet function - vWF - PFA-100 - aspirin-like defect - thromboxane B₂

Full Text

References

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