Quantitation of Cell-Derived Microparticles in Blood Products and Its Potential Applications in Transfusion Laboratories

Egarit Noulsri, PhD

Disclosures

Lab Med. 2020;51(5):452-459. 

In This Article

Abstract and Introduction

Abstract

Cell-derived microparticles (MPs) are small fragments released from various cells when they are activated or undergo apoptosis. In the field of transfusion medicine, a number of studies have documented increased levels of MPs in blood products, which have been associated with multiple factors, including donor variability, blood component processing, and storage. In addition, transfusions that contain high levels of MPs are linked to posttransfusion complications. Considering the clinical importance of MP levels, transfusion laboratories should routinely screen blood products for them. However, this practice is not yet applied routinely, perhaps in part because of a lack of understanding of how to apply MP data to transfusion medicine. We describe the methods used to quantitate MPs in blood components and discuss the application of these quantitative data in routine transfusion laboratories in order to manage quality, improve the outcomes of transfusions, and minimize their complications.

Introduction

In recent years, the field of transfusion medicine has seen increased study of cell-derived microparticles (MPs). A number of studies have demonstrated the presence of MPs in packed red blood cells, platelet concentrate, and fresh frozen plasma in storage.[1–3] Other studies have suggested the presence of procoagulant activities of these MPs through the expression of tissue factors and negatively charged phospholipids to initiate the coagulation pathway.[4,5] MPs have been shown to accumulate during storage, and transfusion products that contain them are thought to be associated with transfusion complications.[6–9] This relationship is supported by clinical studies that have shown an association between adverse clinical outcomes and blood products that have been stored for longer periods of time.[10,11] Although this association has been advanced by research results, it has had only limited application to transfusion laboratories.

This article first provides a brief overview of MPs and outlines current knowledge regarding methods of determining MP concentrations in blood products. Then, it discusses the rationale for the routine use of quantitative data about MPs to increase the quality of blood products prepared in transfusion laboratories. Furthermore, it discusses how quantitating MPs could reduce the complications related to transfusions and improve transfusion outcomes.

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