Prospective study of applying testing strategy to platelet concentrate units in a trial to increase platelet shelf life

The extension of platelet storage from five to eight days was based on the functional quality and bacterial safety. It was the aim of the current study to implement a testing strategy for extended platelet shelf life up to 8 days with optimal achievement of patient safety and adequacy of treatment. Twenty random-donor platelet concentrates RDPCs were prepared under routine conditions by platelet-rich plasma [PRP] protocol then stored at 22°C under Constant agitation for 8 days. The storage changes were assessed on days 1, 5 and 8. for morphology [platelet indices and swirling], metabolic function [p1-I and glucose], cell integrity [lactate dehydrogenase "LDH"], and activation markers [flow Cytometrie analysis of CD62 and CDG3]. Correlation analysis, between the studied parameters at previous time-points storage, was performed. Microbiological culture was carried out on days 1 and 8 using automated microbial detection BACTEC system. A significant decrease in platelet counts during storage, accompanied by significant increase in mean platelet volume [MPV], was noticed. Changes in pH, glucose, and swirling were within the acceptable range. LDH levels were significantly increased on days 5 and 8. Although a gradual increase of CD62 and CD63 surface expression was seen with increasing storage time, it was not statistically significant except at day 1 for both markers and day 8 for CD62 only. A correlation between pH and glucose levels at days 5 and 8 was observed and between pH and CD62 and CD63 at days 8 and 5 respectively. All the 20 PC units were culture negative. We concluded that, the in vitro quality of the stored platelets was maintained until day 8 namely platelet Count, indices and swirling phenomena. In addition, pH, glucose remained within the acceptable range, while recorded LDH levels were considerably increased. Platelets were found to be activated at day 1, likely as a consequence of manipulation during collection and processing, but are not further progressively activated with increasing storage time. BACTEC system is suitable as rapid screening bacterial detection device for PCs

Soluble intercellular adhesion molecule-1 and lymphocyte function associated antigen-1 in viral related chronic liver diseases

We attempted to assess the relationship between soluble intercellular adhesion molecules-I [sICAM-1] in serum and ascitic fluid and its counterpart ligand, lymphocyte function associated antigen-1 [LFA-1] on peripheral blood lymphocytes, accompanied by biochemical and haematological markers of disease activity in patients with viral related chronic liver disease [CLD] classified into Child-Pugh class A to C. Serum and ascitic fluid levels of sICAM using enzyme-linked immunosorbent assay and LFA-1 expression on peripheral lymphocytes using monoclonal antibodies by flow cytometry, were measured in 44 viral-related CLD patients, and 16 healthy controls. All patients were positive for HCV-RNA in their sera, with coexistence of HBV in 5 patients. According to standard criteria of Child-Pugh classification, patients were divided into 3 groups; Child A class [17 cases], B [16 cases] and C [11 cases]. Only 17 out of 44 patients, had ascitis complicating liver cirrhosis [6 from group B and all group C] and their ascitic fluid samples were tested for bacterial detection besides sICAM. Correlation analyses between studied parameters were performed. A significant gradual increase of serum sICAM-1 level was observed in all patients compared to the control, with highest values in Child C group. Serum sICAM exhibited significant direct correlations with prothrombin time [PT], ALT and LFA-1 expression on lymphocytes while inversely correlated with serum albumin and absolute lymphocytic counts. Concentration of sICAM-1 in the uninfected ascitic fluid of the studied cirrhotic patients was tremendously lower than that in serum. Statistically significant reduction of the% of LFA-1 expression on lymphocytes was noticed on comparing Child A group to the control followed by a gradual irrelevant increase with progressing Child grading. In chronic viral hepatitis, serum levels of sICAM-1 has a prognostic significance of the synthetic capacity of the liver, also it could be considered as an additional useful marker of necro-inflammatory activity subsequently, may be helpful, especially in patients in which liver biopsy is not possible. Conversely, measurement of sICAM in the uninfected ascitic fluid is unpredictable marker being present in trace amounts. The increased serum sICAM-1 concomitant with increased LFA-1 expression on peripheral lymphocytes with advancement of the disease can reflect the increased adhesion of these cells to their ligand on endothelial cells

Asessment of platelet activation in coupled schistosomiasis and viral hepatitis infection: contribution to complexity of course and development of complications

This study assessed platelet activation and possible contribution to the pathogenesis of liver cirrthosis [LC], heaptocellular carcinoma [HCC] and portal vain thrombosis [PVT].forty five patients with LC caused by dual schistosomsis and viral hepatitis infections were enrolled in the study, 15 had LC only, 15 were complicated with HCC, and 15 were complicated with PVT, addition to healthy controls. Platelet morphological parameters including platelet count, platelet crit, mean platelet volume [MPV] and platelet distribution width [PDW], as well as platelet activation as evidenced by measuring soluble platelet selectin [sP-selectin] level and the release of beta thromboglobulin [beta-TG], transforming growth factor beta-1 [TGF-beta1] and platelet derived factor-AA [PDGF-AA] were evaluated. The results obtained revealed significant reduction in platelet count, platelet crit and MPV while PDW was significantly increased in all LC patients in comparison to controls. sP selectin, beta-TG, TGF-beta1 and PDGF-AA revealed significant increase in all diseased when compared to control group. Patients complicated with HCC or PVT demonstrated significant increase in the aforementioned parameters in comparison to patients with LC only patients with PVT showed significant increase versus HCC patients. These findings indicate that platelet activation is a prominent feature in LC and its serious complication HCC and PVT This activation can play an important role the in pathogenesis of LC, HCC and PVT in patients with mixed schistosomiasis and viral hepatitis infections such patients need careful medical attention and effective treatment. Stabilization of the activated platelets and the dual suppression of PDGF and TGF-beta1 could be new therapeutic strategies against LC and its sequels.