Impact of glucose and acetate on the characteristics of the platelet storage lesion in platelets suspended in additive solutions with minimal plasma

Background and Objectives Glucose and acetate have been proposed to be required elements in platelet storage media. This study investigated the role of these compounds on the varied elements that comprise the platelet storage lesion. Materials and Methods For each replicate, four pooled and split ABO group-specific buffy coat-derived platelet concentrates were suspended in an in-house additive solution with minimal plasma and varying final concentrations of acetate or glucose. Units were sampled on days 2, 3, 6, 8 and 10 and tested for markers of platelet morphology, activation, function, metabolism and indicators of cell death. Results The absence of glucose was associated with a decrease in ATP, falling to a mean of 1 center dot 1 +/- 0 center dot 1mol/1011 plts in units with no added glucose compared with 4 center dot 2 +/- 0 center dot 6mol/1011 plts (P<0 center dot 001) in units with 30mm glucose. As glucose became depleted, the decrease in ATP to levels below 3mol/1011 plts was associated with an increase in both annexin V binding and intracellular free calcium. In units lacking exogenous acetate, ATP levels on day 10 were 5 center dot 2 +/- 1 center dot 5mol/1011 plts compared with 2 center dot 7 +/- 0 center dot 9mol/1011 plts in units with 56mm acetate (P=0 center dot 006). Higher concentrations of exogenous acetate were associated with a lower hypotonic shock response and higher surface expression of CD62P suggestive of a dose dependency. Conclusion Under current physical storage conditions, glucose appears necessary for the maintenance of platelets stored as concentrates in minimal volumes of plasma. The addition of acetate was associated with increased platelet activation and reduced ATP levels.