Metabolic status of platelet concentrates during extended storage: improvement with pharmacological inhibitors and reduced surface-to-volume ratio.

The depletion of plasma nutrients and buffering capacity may present a potential barrier to the long-term liquid storage of platelet concentrates (PC). We have found that PC prepared with reversible inhibitors of platelet activation added to the citrate anticoagulant and stored at a reduced surface-to-volume (S/V) ratio have a much slower rate of lactate build-up (p less than 0.01), slower consumption of glucose (p = 0.05), and more stable pH (p less than 0.01) than controls. By pO2 and pCO2 measurements, PC prepared with inhibitors showed evidence of continued respiration and responsiveness even after storage at 22 degrees C for 15 days. In addition, these PC released only 11% of the total cellular LDH during the storage period as compared to the release of 43-67% of the total LDH in control PC. Maximum benefit of the inhibitors was seen after reduction of the S/V ratio of the storage container, which was made possible by the reduced metabolic demands of platelets stored in the unactivated state. These data suggest that the fall in pH and loss of platelet integrity associated with the platelet storage lesion are correlated with a high metabolic rate which can be controlled by inhibiting the activation of platelets during preparation and storage. The use of these inhibitors and reduced bag surface area may make prolonged liquid storage of platelets feasible.