Sanne de Bruin

In chapter 6 we conducted a randomized controlled trial to assess whether storage of RBCs in the experimental alkaline, chloride-free, additive solution PAGGGM (phos- phate-adenine-glucose-guanosine-gluconate-mannitol)) resulted in a higher post transfusion recovery (PTR) and better preservation of metabolism after transfusion compared to storage in the current standard SAGM. We found that glycolysis and redox metabolism were better preserved in PAGGGM stored RBCs compared to SAGM stored RBCs. However, this did not result in a higher PTR. Furthermore, 2 days stored RBCs stored in SAGM, had a higher 2- to 7-day PTR, compared to 35 days stored RBCs. Finally, themetabolic storage lesionwas reversible in RBCs that remain in circulation after trans- fusion. The differences in glycolysis, redox and purine metabolism remained present in RBCs, up to one day after transfusion. In chapter 7 we validated a novel method to label platelets with biotin. The current gold standard is labelling with radioactive isotopes including Indium-111 and Chromium-51. Since the use of radioactive labelling is inmost EU countries, including the Netherlands, not allowed in vulnerable patient groups, a non-radioactive alternative is desirable. We showed that biotin is a feasible alternative. Platelet labelling with biotin itself did not affect the quality of platelets. The procedural steps resulted in a small increased platelet activation. However, this biotinylated platelet product still fulfilled all quality criteria from the Dutch blood bank (Including: annexin V expression and CD62P activ- ity). Biotinylated platelets may be a safe alternative for radioactive labelled platelets in vulnerable patients including critically ill patients. Besides giving important insights in the PTR of donor PLTs in different patient cohorts, the biotinylation of PLTs allows assessment of the quality of new blood products. Finally, labelling with biotin has as advantage that biotin labelled platelets can be isolated from the recipient’s circulation after transfusion.