Correlation of cytokine elaboration with mononuclear cell adhesion to platelet storage bag plastic polymers: a pilot study

The basis for many febrile nonhemolytic transfusion reactions associated wi th platelet transfusion therapy is cytokine elaboration and accumulation in the storage bag, which correlate with the leukocyte content and the length of platelet storage. We propose that a possible additional variable in the elaboration and accumulation of cytokines is the differential adhesion of mononuclear cells to the plastic substrate of the platelet storage bag. We hypothesize that mononuclear cell adhesion-induced cytokine release is grea ter in random-donor platelet bags composed of the polyolefin polymer compar ed to the single-donor apheresis platelet bags composed of the polyvinyl ch loride polymer with the tri-(2-ethylhexyl) trimellitate (TEHTM) plasticizer . For four blood donors, we demonstrate preferential mononuclear cell adhes ion, in vitro, to discs of polyolefin polymer versus discs of polyvinyl chl oride polymer with the TEHTM plasticizer. Scanning electron microscopy corr oborates this, In addition, proinflammatory cytokine (interleukin 1 beta [I L-1 beta] and tumor necrosis factor alpha [TNF-alpha]) levels are greater i n culture wells containing discs of polyolefin polymer than in those contai ning discs of polyvinyl chloride polymer with the TEHTM plasticizer, and ev en more so in storage bags containing polyolefin polymer versus polyvinyl c hloride polymer with the TEHTM plasticizer (IL-1 beta, TNF-alpha, IL-6, and IL-8), This study suggests, for the first time, that differential plastic substrate mononuclear cell adhesion may contribute to cytokine release duri ng platelet storage. This may represent an additional variable in the patho physiology of febrile nonhemolytic transfusion reactions in patients receiv ing stored platelet units.