Treatment of Dilution Coagulopathy by Fibrinogen and Platelet Concentrates

Medication-related osteonecrosis of the jaw (MRONJ) is one of the most interesting diseases in the field of maxillofacial surgery. In addition to bisphosphonates, the use of antiresorptive and antiangiogenic agents is known to be the leading cause. However, the exact pathogenesis of MRONJ has not been established, and various hypotheses have been proposed, such as oxidative stress-related theory. As a result, a definitive treatment protocol for MRONJ has not been identified, while various therapeutic approaches are applied to manage patients with MRONJ. Although the surgical approach to treat osteomyelitis of the jaw has been proven to be most effective, there are limitations, such as recurrence and delayed healing. Many studies and clinical trials are being conducted to develop another effective therapeutic modality. The use of some materials, including platelet concentrates and bone morphogenetic proteins, showed a positive effect on MRONJ. Among them, teriparatide is currently the most promising material, and it has shown encouraging results when applied to patients with MRONJ. Furthermore, cell therapy using mesenchymal stem cells showed promising results, and it can be the new therapeutic approach for the treatment of MRONJ. This review presents various treatment methods for MRONJ and their limitations while investigating newly developed and researched molecular and cellular therapeutic approaches along with a literature review.

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The Hemostatic Effect of 51Cr-Labelled Platelets

10.1055/s-0039-1689680 ◽

1975 ◽

Author(s):

J. Björnson ◽

I. Aursnes

Keyword(s):

Whole Body ◽

Platelet Concentrates ◽

Platelet Aggregability ◽

Hemostatic Effect ◽

Normal Platelet ◽

Labelling Procedure

In the interpretation of data obtained with 51Cr-labelled platelets it is vital to know whether they are functionally normal. Although survival of 51Cr-labelled platelets in vivo appears to be normal, platelet aggregability- has recently been shown to be reduced after the labelling procedure (Björnson, J., Sc and. J. Haemat. 13, 252–259).The aim of the present study was to examine the hemostatic effect of labelled platelets. Rabbits were made thrombocytopenic (< 35,000/μ1) by whole body irradiation. Bleeding times were recorded after standardized cuts on the inner side of the ear, a method showing an acceptable reproducibility (< 3 min in normals). The animals were then transfused with labelled platelet concentrates, increasing the platelet levels to about 200,000/μ) blood. Bleeding times of more than 15 min before transfusion were almost normalized 1 and 4 hours after transfusion. In controls transfusion of PRP led to similar shortening of bleeing time.It is concluded that platelets subjected to the 51Cr-labelling procedure to a large extent retain their hemostatic ability.

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The Effect Of Storage On Platelet Morpholog

10.1055/s-0038-1653241 ◽

1981 ◽

Author(s):

A Sturk ◽

L M Burt ◽

T Hakvoort ◽

J W ten cate ◽

N Crawford

Keyword(s):

Electron Microscopy ◽

Membrane Structure ◽

Room Temperature ◽

Surface Membrane ◽

Platelet Concentrates ◽

Room Temperature Storage ◽

Short Survival ◽

Transmission Electron ◽

Temperature Storage ◽

Morphological Correlation

Platelet concentrates were stored for one, two or three days at 4°C (unagitated) or room temperature (unagitated and linearly agitated). The morphology of platelets in platelet concentrates, directly after twice washing at room temperature and after 60 min incubation of the washed platelets at 37°C was investigated by both scanning and transmission electron microscopy.Platelets in the freshly prepared concentrates are slightly activated, i.e. show some pseudopod formation. At 4°C platelets rapidly loose their discoid shape. After three days their surface membrane shows extensive folding, they are slightly vacuolated and have lost most of their granules. Incubation of these cold-stored platelets at 37°C does not induce reversal to the discoid shape.Room temperature storage results in reversal of the slight initial platelet activation. After three days unagitated platelets are slightly more vacuolated than platelets stored with agitation. Room temperature storage usually results in remarkably well preserved, discoid platelets. Occasionally however, agitated platelet concentrates contain a high proportion of odd shaped cells. As platelets stored at 4°C did not became discoid after incubation at 37°, the altered membrane structure could provide an explanation for their short survival upon transfusion. Our results also provide a morphological correlation with the slightly better recovery and survival of platelets stored agitated vs.- non-agitated platelets at room temperature.

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Complete Inactivation of Blood Borne Pathogen Trypanosoma cruzi in Stored Human Platelet Concentrates and Plasma Treated With 405 nm Violet-Blue Light

Frontiers in Medicine ◽

10.3389/fmed.2020.617373 ◽

2020 ◽

Vol 7 ◽

Author(s):

Katarzyna I. Jankowska ◽

Rana Nagarkatti ◽

Nirmallya Acharyya ◽

Neetu Dahiya ◽

Caitlin F. Stewart ◽

...

Keyword(s):

Trypanosoma Cruzi ◽

Human Plasma ◽

Blue Light ◽

Chagas Disease ◽

Light Treatment ◽

Platelet Concentrates ◽

Complete Inactivation ◽

Pathogen Reduction ◽

Biochemical Indices

The introduction of pathogen reduction technologies (PRTs) to inactivate bacteria, viruses and parasites in donated blood components stored for transfusion adds to the existing arsenal toward reducing the risk of transfusion-transmitted infectious diseases (TTIDs). We have previously demonstrated that 405 nm violet-blue light effectively reduces blood-borne bacteria in stored human plasma and platelet concentrates. In this report, we investigated the microbicidal effect of 405 nm light on one important bloodborne parasite Trypanosoma cruzi that causes Chagas disease in humans. Our results demonstrated that a light irradiance at 15 mWcm−2 for 5 h, equivalent to 270 Jcm−2, effectively inactivated T. cruzi by over 9.0 Log10, in plasma and platelets that were evaluated by a MK2 cell infectivity assay. Giemsa stained T. cruzi infected MK2 cells showed that the light-treated parasites in plasma and platelets were deficient in infecting MK2 cells and did not differentiate further into intracellular amastigotes unlike the untreated parasites. The light-treated and untreated parasite samples were then evaluated for any residual infectivity by injecting the treated parasites into Swiss Webster mice, which did not develop infection even after the animals were immunosuppressed, further demonstrating that the light treatment was completely effective for inactivation of the parasite; the light-treated platelets had similar in vitro metabolic and biochemical indices to that of untreated platelets. Overall, these results provide a proof of concept toward developing 405 nm light treatment as a pathogen reduction technology (PRT) to enhance the safety of stored human plasma and platelet concentrates from bloodborne T. cruzi, which causes Chagas disease.

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