Generation of kinins during preparation and storage of whole blood-derived platelet concentrates.

Abstract:

BACKGROUND:Leukoreduction of platelet (PLT) concentrates (PCs) may be associated with hypotension in recipients, and a role for bradykinin (BK)-related peptides has been proposed for this side effect. STUDY DESIGN AND METHODS:The concentration of BK and one of its vasoactive metabolites, des-arginine(9)-BK (des-Arg(9)-BK), was measured in a large number of PCs as a function of leukoreduction and storage duration with specific enzyme immunoassays and complementary techniques. RESULTS:On Day 0 of storage, kinins were detected in leukoreduced and unfiltered PCs at a concentration lower than 100 pg per mL. During storage, both kinin levels peaked on Day 5 of storage, with a concentration higher than 1 ng per mL in 22 percent of PCs whether filtered on Day 0 or not. Physicochemical and pharmacologic characterizations of immunoreactive kinins confirm their nature. In vitro activation of the contact system of the corresponding PLT-poor plasma showed that a high kinin concentration on Day 5 of the storage corresponded with a low kinin-forming capacity of plasma. On Day 7, BK was no longer elevated presumably due to its degradation and the depletion of kinin-forming capacity of the plasma in stored PCs. The activities of metallopeptidases that metabolize BK-related peptides in plasma from PCs were at levels similar to those recorded in the plasma of a normal reference population and were unaffected by storage. CONCLUSION:Storage of PCs contributes to the hydrolysis of high-molecular-weight kininogen and generation of pharmacologically relevant BK levels that might pose a hazard in susceptible patients.

journal_name

Transfusion

journal_title

Transfusion

authors

Moreau ME,Thibault L,Désormeaux A,Chagnon M,Lemieux R,Robillard P,Marceau F,Colman RW,Lepage Y,Rivard GE,Adam A

doi

10.1111/j.1537-2995.2007.01097.x

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

410-20

issue

3

eissn

0041-1132

issn

1537-2995

pii

TRF01097

journal_volume

47

pub_type

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