TEG PlateletMapping assay results may be misleading in the presence of cold stored platelets

T G Scorer*, L Fitzgibbon, R Aungraheeta, U Sharma, G C Peltier, C S McIntosh, K M Reddoch-Cardenas, A Meyer, A P Cap, A D Mumford

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Background: Viscoelastic tests (VETs) are used widely to monitor hemostasis in settings such as cardiac surgery. There has also been renewed interest in cold stored platelets (CSP) to manage bleeding in this setting. CSPs are reported to have altered hemostatic properties compared to room temperature platelets (RTP), including activation of GPIIb/IIIa. We investigated whether the functional differences between CSP and RTP affected the performance of the PlateletMapping VET on the TEG 5000 and 6s analyzer.

Method: Platelet concentrates were divided equally into CSP (stored at 4°C±2°C) and RTP (stored at 22°C±2°C) fractions. Whole blood was treated to induce Platelet dysfunction (WBIPD) by incubating with anti-platelet drugs (1.0μM ticagrelor and 10μM aspirin) or by simulating cardiopulmonary bypass. WBIPD samples were then mixed with 20% by volume of CSP or RTP to model platelet transfusion before analysis using the PlateletMapping VET.
Results: Addition of CSP to WBIPD increased the PlateletMapping MAFIBRIN and MAADP parameters with the TEG 5000 analyzer (both p<0.0001 compared to addition of buffer alone). This effect was not observed with RTP. The differential effect of CSP on the MAFIBRIN corrected after pre-incubation with the GPIIb/IIIa antagonist tirofiban and was quantitatively less with the PlateletMapping test for the TEG 6s analyzer which contains the GPIIb/IIa antagonist abciximab.
Discussion: The PlateletMapping MAFIBRIN and MAADP test results may be misleadingly high with CSP, particularly with the TEG 5000 analyzer, most likely due to constitutive activation of GPIIb/IIIa on CSP during storage. TEG PlateletMapping results should be interpreted with caution following CSP transfusion.
Original languageEnglish
Pages (from-to)S119-S123
Number of pages5
JournalTransfusion
Volume60
Issue numberS3
DOIs
Publication statusPublished - 1 Jun 2020

Fingerprint Dive into the research topics of 'TEG PlateletMapping assay results may be misleading in the presence of cold stored platelets'. Together they form a unique fingerprint.

Cite this