@article{Millar2018,
title = {Routine Screening Method for Microparticles in Platelet Transfusions},
author = {Millar, D., Murphy, L., Labrie, A., Maurer-Spurej, E.},
url = {https://www.jove.com/video/56893/routine-screening-method-for-microparticles-in-platelet-transfusions},
doi = {10.3791/56893},
year = {2018},
date = {2018-01-31},
journal = {Journal of Visual Experiments},
number = {131},
abstract = {Platelet inventory management based on screening microparticle content in platelet concentrates is a new quality improvement initiative for hospital blood banks. Cells fragment off microparticles (MP) when they are stressed. Blood and blood components may contain cellular fragments from a variety of cells, most notably from activated platelets. When performing their roles as innate immune cells and major players in coagulation and hemostasis, platelets change shape and generate microparticles. With dynamic light scattering (DLS)-based microparticle detection, it is possible to differentiate activated (high microparticle) from non-activated (low microparticle) platelets in transfusions, and optimize the use of this scarce blood product. Previous research suggests that providing non-activated platelets for prophylactic use in hematology-oncology patients could reduce their risk of becoming refractory and improve patient care. The goal of this screening method is to routinely differentiate activated from non-activated platelets. The method described here outlines the steps to be performed for routine platelet inventory management in a hospital blood bank: obtaining a sample from a platelet transfusion, loading the sample into the capillary for DLS measurement, performing the DLS test to identify microparticles, and using the reported microparticle content to identify activated platelets.

INTRODUCTION},
keywords = {Microparticle, Platelet Activation Status},
pubstate = {published},
tppubtype = {article}
}

@article{Maurer-Spurej2016b,
title = {Could Microparticles Be the Universal Quality Indicator for Platelet Viability and Function?},
author = {Elisabeth Maurer-Spurej and Kate Chipperfield},
editor = {Denese Marks},
url = {https://www.hindawi.com/journals/jbt/2016/6140239/},
doi = {10.1155/2016/6140239},
year = {2016},
date = {2016-11-06},
journal = {Journal of Blood Transfusion},
volume = {2016},
number = {Article ID 6140239},
pages = {11},
abstract = {High quality means good fitness for the intended use. Research activity regarding quality measures for platelet transfusions has focused on platelet storage and platelet storage lesion. Thus, platelet quality is judged from the manufacturer’s point of view and regulated to ensure consistency and stability of the manufacturing process. Assuming that fresh product is always superior to aged product, maintaining in vitro characteristics should preserve high quality. However, despite the highest in vitro quality standards, platelets often fail in vivo. This suggests we may need different quality measures to predict platelet performance after transfusion. Adding to this complexity, platelets are used clinically for very different purposes: platelets need to circulate when given as prophylaxis to cancer patients and to stop bleeding when given to surgery or trauma patients. In addition, the emerging application of platelet-rich plasma injections exploits the immunological functions of platelets. Requirements for quality of platelets intended to prevent bleeding, stop bleeding, or promote wound healing are potentially very different. Can a single measurable characteristic describe platelet quality for all uses? Here we present microparticle measurement in platelet samples, and its potential to become the universal quality characteristic for platelet production, storage, viability, function, and compatibility.},
keywords = {Microparticle, Platelet Activation Status},
pubstate = {published},
tppubtype = {article}
}

@article{Labrie2013,
title = {Characterization of Platelet Concentrates Using Dynamic Light Scattering},
author = {Labrie A, Marshall A, Bedi H, Maurer-Spurej E,},
url = {https://www.karger.com/Article/FullText/350362},
doi = {10.1159/000350362},
year = {2013},
date = {2013-04-01},
journal = {Transfusion Medicine and Hemotherapy},
volume = {40},
number = {2},
pages = {93-100},
abstract = {Background: Each year, millions of platelet transfusions save the lives of cancer patients and patients with bleeding complications. However, between 10 and 30% of all platelet transfusions are clinically ineffective as measured by corrected count increments, but no test is currently used to identify and avoid these transfusions. ThromboLUX® is the first platelet test intended to routinely characterize platelet concentrates prior to transfusion.

Methods: ThromboLUX is a non-invasive, optical test utilizing dynamic light scattering to characterize a platelet sample by the relative quantity of platelets, microparticles, and other particles present in the sample. ThromboLUX also determines the response of platelets to temperature changes. From this information the ThromboLUX score is calculated. Increasing scores indicate increasing numbers of discoid platelets and fewer microparticles. ThromboLUX uses calibrated polystyrene beads as a quality control standard, and accurately measures the size of the beads at multiple temperatures.

Results: Results from apheresis concentrates showed that ThromboLUX can determine the microparticle content in unmodified samples of platelet concentrates which correlates well with the enumeration by flow cytometry. ThromboLUX detection of microparticles and microaggregates was confirmed by microscopy.

Conclusion: ThromboLUX provides a comprehensive and novel analysis of platelet samples and has potential as a non-invasive routine test to characterize platelet products to identify and prevent ineffective transfusions.},
keywords = {Platelet Activation Status},
pubstate = {published},
tppubtype = {article}
}

@article{Maurer-Spurej2009,
title = {Platelet quality measured with dynamic light scattering correlates with transfusion outcome in hematologic malignancies.},
author = {Maurer-Spurej, E., Labrie, A., Pittendreigh, C., Chipperfield, K., Smith, C., Heddle, N., Liu, Y., Yi, Q.-L. and Barnett, M.},
url = {http://onlinelibrary.wiley.com/wol1/doi/10.1111/j.1537-2995.2009.02302.x/full},
doi = {10.1111/j.1537-2995.2009.02302.x},
year = {2009},
date = {2009-10-22},
journal = {Transfusion},
volume = {49},
number = {11},
pages = {2276-2284},
abstract = {BACKGROUND: A clinically meaningful test for platelet (PLT) quality could improve the transfusion management of patients. The aim of this pilot study was to determine whether a new measure of PLT quality and function based on dynamic light scattering (DLS) correlates with transfusion outcome.

STUDY DESIGN AND METHODS: For a total of 160 transfusions, the pretransfusion, 1 hour posttransfusion, and 24-hour posttransfusion PLT counts were routinely measured in 49 patients (31 male, 18 female; age 46 ± 15 years) with hematologic malignancies. The corrected count increments (CCIs) at 1 hour (PLT recovery) and 24 hours (PLT survival) were calculated and used as the transfusion outcome measures. The ThromboLUX score (LightIntegra Technology, Inc., Vancouver, BC, Canada; range, 0-40; cutoff, 12) and the PLT morphology score of the PLT concentrates were determined and compared to transfusion outcome.

RESULTS: The CCIs and ThromboLUX scores were normally distributed and showed a strong correlation (n = 96, in the mixed regression model the adjusted coefficient is R = 0.6292, p < 0.0001), while other variables such as product type, age, and microscopic PLT morphology score were not correlated with transfusion outcome (p > 0.05). Importantly, 12 of 96 transfusions with poor PLT quality were clinically ineffective, that is, did not adequately increase the PLT counts in the recipients. One patient died after receiving three consecutive ineffective PLT transfusions with a low ThromboLUX score.

CONCLUSION: In this pilot study, the ThromboLUX score strongly correlated with transfusion outcome (PLT recovery and survival) independent of clinical and product issues.},
keywords = {dynamic light scattering, Platelet Activation Status, Platelet Refractoriness},
pubstate = {published},
tppubtype = {article}
}

@article{Maurer-Spurej2007,
title = {Past and Future Approaches to Assess the Quality of Platelets for Transfusion},
author = {Elisabeth Maurer-Spurej and Kate Chipperfield},
url = {http://www.tmreviews.com/article/S0887-7963(07)00044-2/fulltext},
doi = {10.1016/j.tmrv.2007.05.005},
year = {2007},
date = {2007-10-01},
journal = {Transfusion Medicine Review},
volume = {21},
number = {4},
pages = {295-306},
abstract = {Abstract
Full Text
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References
No automated test exists to routinely measure platelet quality. Currently, the short, 5-day shelf life of platelet concentrates is largely dictated by the risk associated with bacterial contamination and not by platelet quality. With the implementation of bacterial testing and pathogen inactivation, platelet quality will become the major determinant for the shelf life of platelet concentrates. However, extended use of platelet concentrates stored beyond 5 days will require quality testing. In addition, high platelet quality would be expected to result in improved clinical efficacy, determined by count increment, improved hemostasis, and lower risk for adverse reactions in recipients. No in vitro quality test has yet demonstrated a good correlation with clinical efficacy or improved hemostasis. This review focuses on those tests of platelet quality that are based on platelet morphology. These include visual inspection of swirling, microscopic morphology score, measurement of light transmission through platelet concentrates, and platelet light scattering techniques. Recently, a new test for platelet quality has been introduced that uses dynamic light scattering. The advantages and remaining challenges for dynamic light scattering before it can become a routine platelet quality test are discussed.},
keywords = {Platelet Activation Status},
pubstate = {published},
tppubtype = {article}
}