Blood platelet kinetics and platelet transfusion

Abstract

The discovery of citrate anticoagulant in the 1920s and the development of plastic packs for blood collection in the 1960s laid the groundwork for platelet transfusion therapy on a scale not previously possible. A major limitation, however, was the finding that platelet concentrates prepared from blood anticoagulated with citrate were unsuitable for transfusion because of platelet clumping. We found that this could be prevented by simply reducing the pH of platelet-rich plasma to about 6.5 prior to centrifugation. We used this approach to characterize platelet kinetics and sites of platelet sequestration in normal and pathologic states and to define the influence of variables such as anticoagulant and ABO incompatibility on post-transfusion platelet recovery. The "acidification" approach enabled much wider use of platelet transfusion therapy until alternative means of producing concentrates suitable for transfusion became available.

Figure 1. Survival of autologous “citrate platelets” after transfusion to a normal subject.

Approximately 75% of labeled platelets were recovered in the circulation immediately after being transfused. The red area denotes the range of blood platelet radioactivity after the injection of Cr⁵¹-labeled “EDTA platelets” on 10 occasions in 7 normal subjects. Adapted from ref. .