Hemorrhagic Risks of Percutaneous Dilated Tracheotomy in Thrombocytopenia

The objective: to assess the incidence and influence of platelets level on the hemorrhagic complications during percutaneous dilated tracheotomy (PDT) in patients with thrombocytopenia.Subjects and Methods. The study included 85 consecutive patients with varying degrees of thrombocytopenia at the stages of hematopoietic stem cell transplantation. The control group included 56 patients who underwent classical tracheotomy. The study group included 29 patients who underwent PDT (Griggs method). The operations were performed for prolonged artificial pulmonary ventilation. When the platelets level was below 20 × 109/L, platelet concentrate transfusion was performed before the operation.Results. The incidence of hemorrhagic complications in patients with thrombocytopenia during PDT was 13.8% (95% CI 9.13–18.45%). In open tracheotomy, the bleeding rate was 3.8% (95% CI 2.65–4.49%). These results are comparable to the incidence of hemorrhagic complications in patients with normal platelet counts. The influence of the platelet level on the presence of hemorrhagic complications in both groups was not established.Conclusion. Thrombocytopenia is not a contraindication to performing PDT. However, platelet concentrate transfusion should be performed in patients with platelet counts less than 20 × 109/L. An experienced team of anesthesiologists and endoscopists can reduce the incidence of other complications.

Regenerative Potential of Platelet Concentrate Lysate in Mechanically Injured Cartilage and Matrix-Associated Chondrocyte Implantation In Vitro

Adjuvant therapy in autologous chondrocyte implantation (ACI) can control the post-traumatic environment and guide graft maturation to support cartilage repair. To investigate both aspects, we examined potential chondro-regenerative effects of lysed platelet concentrate (PC) and supplementary interleukin 10 (IL-10) on mechanically injured cartilage and on clinically used ACI scaffolds. ACI remnants and human cartilage explants, which were applied to an uniaxial unconfined compression as injury model, were treated with human IL-10 and/or PC from thrombocyte concentrates. We analyzed nuclear blebbing/TUNEL, sGAG content, immunohistochemistry, and the expression of COL1A1, COL2A1, COL10A1, SOX9, and ACAN. Post-injuriously, PC was associated with less cell death, increased COL2A1 expression, and decreased COL10A1 expression and, interestingly, the combination with Il-10 or Il-10 alone had no additional effects, except on COL10A1, which was most effectively decreased by the combination of PC and Il-10. The expression of COL2A1 or SOX9 was statistically not modulated by these substances. In contrast, in chondrocytes in ACI grafts the combination of PC and IL-10 had the most pronounced effects on all parameters except ACAN. Thus, using adjuvants such as PC and IL-10, preferably in combination, is a promising strategy for enhancing repair and graft maturation of autologous transplanted chondrocytes after cartilage injury.

Various applications of platelet rich fibrin in dentistry: A literature review

Platelet rich fibrin is a part of platelet concentrate, that is derived from human blood and made through the process of centrifugation. It is an autogeneous bio material, which basically constitutes various growth factors, and cytokines that are entrapped in its matrix of fibrin. Platelet rich fibrin provides ideal environment for healing of the wound and the regeneration of the tissue. Platelet rich fibrin helps in regulating the inflammation process and increases the healing process.

Complete Genome Sequence of Staphylococcus aureus PS/BAC/169/17/W, Isolated from a Contaminated Platelet Concentrate in England

We report the genome sequence of Staphylococcus aureus PS/BAC/169/17/W, which was isolated in 2017 from a contaminated platelet concentrate at the National Health Service Blood and Transplant. Assessment of the genome sequence of this strain showed the presence of a 2,753,746-bp chromosome and a plasmid of 2,762 bp.

Complete Genome Sequence of Staphylococcus aureus CI/BAC/25/13/W, Isolated from Contaminated Platelet Concentrates in England

We present the genome sequence of Staphylococcus aureus CI/BAC/25/13/W, which was isolated in 2013 as a contaminant of a platelet concentrate with abnormal clotting at the National Health Service Blood and Transplant. Assessment of the genome sequence showed the presence of one chromosome (2,719,347 bp) and one plasmid (1,533 bp).

The concept of hemostasis disorders in severe leptospirosis

The purpose of the research to create a concept for diagnostics and therapy of hemostasis disorders of patients with severe leptospirosis.Patients and Methods. The study included 474 patients with severe serologically confirmed leptospirosis with a favorable outcome of the disease and 31 patients with fatal outcome (total 505 people). Variant of coagulopathy was determined by using a set of special methods for studying hemostasis. The influence of platelet concentrate transfusion, plasma exchange and various tactics of glucocorticoid therapy on patient survival and correction of hemostasis disorders was evaluated. Survival analysis was made using Kaplan-Meyer method with a Cox proportional intensity model. Relative risk (RR) was calculated with a 95% confidence interval (CI).Results: the use of early diagnosis of coagulopathy variants and the use of a differentiated therapy regimen in the choice of the variant of hemostasis disorder led to a decrease of mortality from 16.45% to 11.5% and decrease in the consumption of platelet concentrate and fresh frozen plasma.Conclusion: patients with severe leptospirosis develop a multivariate hemostatic pathology: isolated thrombocytopenia (38%) with thrombotic microangiopathy (20,5%), disseminated intravascular coagulopathy (37,1%), uremic coagulopathy (4,9%), hepatic coagulopathy (3,4%). Plasma exchange in thrombotic microangiopathy is pathogenetically justified. Also, plasma exchange is pathogenetically justified in order to reduce plasma volume in DIC syndrome with consumption coagulopathy and hepatic coagulopathy. The use of GCS in isolated thrombocytopenia can be effective and safe in both “medium doses” and in the form of “pulse therapy” if the following conditions are met: acute renal injury (AKI) III stage according to AKIN and the absence of renal replacement therapy (RRT). The main indication for platelet concentrate transfusion in severe leptospirosis is extremely severe thrombocytopenia (grade 4) with active life-threatening bleeding at the time of transfusion.

The Differences Levels of RANTES and PF4 Based on the Storage of Platelet Concentrate

Blood component transfusion is often used as the primary therapy as it is still considered safe. Platelet Concentrate (PC) transfusion plays a critical role in preventing bleeding in patients with severe thrombocytopenia. Allergic reactions are the most frequent transfusion reactions after PC administration. Regulated on Activation Normal T-Cell Expressed and Secreted (RANTES) and Platelet Factor 4 (PF4) cytokines released by platelets during PC storage are responsible for allergic reactions after transfusion. The purpose of this study was to analyze changes in RANTES and PF4 levels during PC storage. This study was an observational analytical research with a time series design carried out at the Clinical Pathology Laboratory and Blood Bank of the Dr. Soetomo Hospital, Surabaya, from June to July 2019. RANTES and PF4 levels in 27 bags derived from Platelet Rich Plasma (PRP) on storage for day 1, day 3, and day five were measured using the ELISA sandwich method. Subject same variant test or Friedman test was used for statistical analysis. The results showed no significant differences in RANTES and PF4 levels based on the storage duration of PCs on days 1, 3, and 5, with p=0.717, and p=0.614, respectively. There was no difference in the storage of PCs from day 1 to day five, and there was no effect on allergic reactions after PC transfusion.

Platelet Refractoriness Evaluation after Platelet Concentrate Transfusion in Pediatric Leukemia

Platelet transfusion is being used in 67%-75% of hematology malignancies including leukemia. Platelet refractoriness is the failure to achieve satisfactory responses to platelet transfusions. Many transfusion centres use 1 hour and 24 hours after transfusion Corrected Count Increment (CCI) value to define platelet refractoriness. To analyze platelet refractory based on CCI-1h and CCI-24h value after Platelet Concentrate (PC) tranfusion in pediatric leukemia and the effect of non immune factors on platelet refractoriness. Subjects were evaluated for platelet count after 10-120 minutes and 18-24 hours of PC tranfusion to calculate CCI-1h and CCI-24h. Platelet Refractoriness was defined when CCI-1h <5×109/L and CCI-24h <4.5×109/L. Each subject was observed for non-immune platelet refractory factors. Interestingly, from 25 PC transfusion there was 20% platelet refractoriness of CCI-1h and 40% of CCI-24h. There was a significant difference CCI-1h and CCI-24h (p=0.027). Non immune factor had no effect for platelet refractoriness. Platelet count should be analyzed after 24 hours PC transfusion to diagnose platelet refractoriness. Further research including immune factor examination is needed.

Antibacterial Effect of Platelet Concentrate and Amniotic Membrane as two Human-derived Biological Products

Background and Objectives: Regarding the increasing spread of bacterial resistance, researchers are always interested in finding effective antibiotics of natural origin. The amniotic membrane and blood platelet concentrate are two biological products with an antibacterial effect. The present study aimed to investigate the antibacterial effect of the biological products on broad-spectrum MBL-producing Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus. Subjects and Methods The amniotic membrane, blood platelet concentrate, S. aureus, and P. aeruginosa isolates were collected from hospitals in Gorgan City, Iran. The isolates were identified using the biochemical tests. The methicillin-resistant S. aureus and MBL-producing P. aeruginosa strains were collected by the combined disk and iodometric methods. The antibacterial effects of platelet serial dilutions of bacteria were prepared using 0.5 McFarland turbidity standard suspension in tubes. Then, different concentrations of bacteria were mixed with platelet. After four different encounter durations, a sample was obtained and cultured on medium and bacterial growth was examined. The amniotic membrane was assessed by disk diffusion methods. Results The results showed that all isolates of P. aeruginosa and S. aureus were MBL producers. The platelet concentrate showed the antibacterial effect on all S. aureus isolates, whereas it lacked such an effect on P. aeruginosa isolates. It indicates that the amniotic membrane has an antibacterial effect on all S. aureus and P. aeruginosa isolates. Conclusion The amniotic membrane and platelet concentrate showed high antimicrobial potential against multidrug-resistant S. aureus and P. aeruginosa pathogens. Therefore, human-derived natural products can be used as a source for efficient antibiotics.