Use of prostaglandin E(1) during preparation of platelet concentrates

A paired study in 10 autologous volunteer donors was undertaken to investigate the efficacy of adding prostaglandin E(1) (PGE(1)) in vitro during routine platelet concentrate (PC) production. After 5 days storage, PCs prepared with PGE(1) were compared with control PCs. In vivo platelet recovery, survival and biodistribution were determined following autologous infusion of indium-111 labelled platelets into volunteers, together with the in vitro evaluation of platelet function and biochemistry. PGE(1) facilitated easier and faster platelet resuspension following centrifugation. After storage there were few significant in vitro differences between PCs prepared with PGE(1) and control PCs. The artifactual leucocyte concentration was significantly lower in the presence of PGE(1), suggesting less platelet aggregates had been formed during storage and beta-thromboglobulin release was significantly reduced by PGE(1), 14.0 +/- 6.0 mu g per 10(9) platelets compared with 22.3 +/- 9.8 mu g per 10(9) platelets in control PCs, (P < 0.01), indicating PGE(1) reduced both platelet aggregation and activation probably at the initial preparation stage, known to produce the greatest trauma. Initial in vivo platelet recovery for PCs prepared with PGE(1) was similar to that of control PCs, 41.1 +/- 12.5% vs. 44.4 +/- 8.0%, respectively, and there were no differences in organ distribution at 24 h. However, in vivo multiple hit survival was reduced in the presence of PGE(1), 5.8 +/- 1.6 days compared with 6.9 +/- 1.4 days in control PCs (P < 0.05). Despite the ability of PGE(1) to facilitate platelet resuspension and inhibit platelet aggregation and activation during preparation of the PCs, the reduced in vivo survival time may preclude the use of PGE(1) during routine PC preparation.