HOW CAN WE IMPROVE PLATELET PREPARATION AND STORAGE

The use of platelet additive solutions to replace the major part of pl asma as storage medium can improve storage through supply of fuel in p latelet metabolism. It is important to avoid platelet activation, e.g. through optimal anticoagulation and gentle procedures at preparation. Leucodepletion of platelet concentrates (PCs) reduces HLA immunizatio n and therapeutic refractoriness. Leucofiltration has become common to obtain leucocyte-depleted PCs, but frequently results in considerable platelet loss. Attempts at improvements must be validated, e.g. by te sting post-transfusion increments and function in vivo. The in vitro b leeding-time test seems to be a valuable tool for the latter purpose. Bacterial contamination of PCs occur more commonly than so far believe d; however, severe clinical complications seem to be relatively rare. Newly available methods for bacterial culture are sufficiently rapid a nd sensitive to be useful in PC testing. Bacterial decontamination, e. g, using psoralen-UVA, may be a future possibility for obtaining safer PCs. (C) 1996 Elsevier Science Ltd.