l‐carnitine decreases glycolysis in liquid‐stored platelets

• Published in: Transfusion (Philadelphia, Pa.) Vol. 40; no. 11; pp. 1313 - 1319
• Main Authors: Sweeney, Joseph D., Blair, Abbe‐Jane, Cheves, Tracey A., Dottori, Secondo, Arduini, Arduino
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Inc 01.11.2000; Blackwell Publishing
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Platelets - metabolism; Blood Preservation; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Carnitine - pharmacology; Cryopreservation; Dose-Response Relationship, Drug; ESC = extent of shape change; Glycolysis - drug effects; HSR = hypotonic shock response; LAC = l‐acetyl‐carnitine; LC = l‐carnitine; Medical sciences; PC(s) = platelet concentrate(s); PRP = platelet‐rich plasma; Time Factors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Human; Liquid state; Blood cell; Platelet; Storage; Preservation; Glycolysis; Levocarnitine; Concentrate; Conditioning; Technique; Metabolism
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1046/j.1537-2995.2000.40111313.x

BACKGROUND: The platelet storage lesion is characterized metabolically by a pH decrease associated with lactic acid generation; a change in platelet morphology from discoid to spherical; a diminished response to in vitro challenge tests, such as the hypotonic shock response (HSR) and extent of shape change (ESC); increased surface P‐selectin expression; and decreased in vivo recovery and survival. Altering storage conditions to improve these measures could allow for extension of the duration of in vitro storage. STUDY DESIGN AND METHODS: ABO‐identical paired platelet concentrates were pooled and then equally divided into two plastic bags. Either l‐carnitine (LC) or an equal volume of saline (control) was added to one container of each pair. Platelets were stored at 20 to 24°C for 5 to 10 days or at 1 to 6°C for 5 days at various concentrations of LC between 0.1 and 15 mM. At the end of storage, pH, glucose consumption, lactate generation, HSR, ESC, and surface P‐selectin expression were measured. In different experiments, paired platelet concentrates were spiked with a Staphylococcus epidermidis suspension in the presence and absence of l‐carnitine at a concentration of 5 mM. RESULTS: At 20 to 24°C and concentrations of LC between 0.1 and 5 mM, there was evidence of better pH preservation, less glucose consumption, and less lactate generation. Only with storage beyond 5 days was a difference present in either surface P‐selectin expression or HSR. An l‐carnitine concentration of 5 mM appeared optimal. l‐carnitine did not enhance the growth of bacteria after 7 to 8 days of storage. CONCLUSION: LC at 5 mM may improve the quality of platelet concentrates that are stored beyond 5 days. There was no indication that LC at this concentration would promote bacterial growth. it may be a useful additive to platelet preservation.