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Essentials of Transfusion Medicine
by Fred V. Plapp MD PhD by BookSurge Publishing
Paperback ~ Release Date: 2008-08-18
List Price: $25.95
Our Price: $21.85

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PLATELET ADDITIVE SOLUTION PLATELETS

Platelet additive solutions (PAS) are crystalloid-based additive solutions that replace a portion of the plasma normally used for platelet storage. PAS solutions have been developed in order to increase platelet viability during storage, minimize the amount of plasma in platelet products, and make more plasma available for other needs.


 

PAS-C (also known as Intersol or PAS 3) was the first PAS approved in the United States by the FDA for storage of apheresis platelets. It contains citrate, phosphate and acetate. PAS-C is added to apheresis platelets towards the end of the collection process. PAS platelets are leukocyte reduced apheresis platelets that are stored in a mixture of 65% PAS and 35% plasma. The residual plasma volume is approximately 90 mL. Storage is the same as conventional platelets; Up to 5 days at 20-24 C with continuous agitation.


 

PAS-C does not contain mannitol or extra adenine or dextrose and therefore its use does not carry the same concerns for neonatal transfusion as the Adsol additive solution used extend the shelf life of red blood cells. Transfusion services that use sterile docking to prepare aliquots of apheresis platelets for pediatric patients can use the same minimum residual volume of PAS plasma as plasma used for conventional apheresis platelets.


 

Platelets stored in PAS-C are just as effective as platelets stored in plasma for treatment of bleeding. There is no difference in corrected count increments at 1 hour and 24 hours post-transfusion.  PAS platelets are not as effective as conventional apheresis platelets in correcting co-existent coagulopathy since they contain only one third the volume of plasma.


 

Due to decreased plasma volume, platelets stored in PAS-C have a 55 to 60% lower risk for transfusion reactions, especially allergic reactions. Theoretically, transfusion of platelets stored in PAS should also have a lower incidence of other plasma-associated transfusion reactions, such as transfusion related acute lung injury (TRALI) and ABO hemolytic reactions. PAS platelets reduce the risk of hemolysis when transfusing ABO mismatched platelets because they have lower titers of anti-A and/or anti-B antibodies. PAS platelets may also eliminate the need for HLA antibody screening of multiparous female donors of apheresis platelets.


 

Collection of platelets stored in PAS may permit collection of more blood products from the same donor during each apheresis donation because the reduced amount of plasma required for platelet storage results in more available plasma for collecting additional products.

 

  1. Heaton WA, Cost and benefits of PAS platelets: A mix of science, quality and value. Transfusion 2014; 54:2597-2601.
  2. Tobian, A, et al. The impact of platelet additive solution apheresis platelets on allergic transfusion reactions and corrected count increment.  Transfusion 2014; 54:1523-1529
  3. Karafin MS, et al. Transfusion 2012; 52:2087-2093

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Chris Plapp
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