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Abstract

PLATELET MEMBRANES VERSUS INTACT PLATELETS: FEASIBILITY AS A POTENTIAL PLATELET SUBSTITUTE

Saleh Nasiri*

Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.

ABSTRACT

The short life time of human platelet units has led to a chronic shortage of fresh platelets in blood transfusion centers. Many approaches have been investigated experimentally to produce new hemostatically active platelet products that are capable of long term storage. In this article products containing platelet membranes such as disintegrated or infusible platelet membrane (IPM) products versus products containing intact platelets such as conventional liquid-stored platelet concentrates, frozen , cold-stored liquid or lyophilized intact platelets will be illustrated with regard to benefits and feasibility as a potential platelet substitute. This review concludes that IPM as a platelet substitute offers many important benefits over products containing intact platelets. IPM may demonstrate efficacy, safety, acceptable tolerability without thrombogenecity, immunogenicity or toxicity. The other main benefits of this product are improved shelf life, ease of storage use and reformulation, reduced viral and bacterial load, decreased refractoriness to platelet transfusion, reduced contaminating red cells and white cells, reduced side effect due to removal of undesirable effects of intracellular and extracellular mediators, achievement hemostatic response without increasing circulating platelet count, the lack of being removed from circulation by immune mechanisms or sepsis and not requiring blood typing. In spite of these benefits, there are still some difficulties in demonstrating its efficacy. Therefore, further human clinical studies will be needed to more fully define the exact role of IPM in the management of patients with thrombocytopenia. Consequently, the approaches that use phospholipid membrane vesicles represent probably the most feasible approach to develop a platelet substitute once it reaches the market.

Keywords: Infusible platelet membrane, Platelet substitute, Intact platelet, Platelet concentrates.


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