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Platelet storage pool defect

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Overview

Platelet storage pool defects (PSPDs) refer to a group of disorders characterized by impaired platelet function due to deficiencies in specific intracellular storage pools, primarily affecting dense granules and α-granules. These defects manifest clinically as bleeding diatheses despite normal platelet counts, impacting patients' quality of life and necessitating careful management of transfusions and potential surgical interventions. PSPDs are relatively rare but significant, particularly in patients with unexplained bleeding tendencies or those undergoing platelet transfusions where functional efficacy is crucial. Understanding these defects is vital in day-to-day practice for accurate diagnosis and effective transfusion strategies to prevent hemorrhagic complications. 2101620

Pathophysiology

Platelet storage pool defects arise from genetic mutations that impair the synthesis, storage, or release of critical granule contents essential for hemostasis. Dense granules, primarily responsible for releasing ADP and calcium ions, and α-granules, which store von Willebrand factor (vWF), growth factors, and coagulation factors, are commonly affected. Mutations in genes such as NBEAL2 and G6PC disrupt the biogenesis and trafficking of these granules, leading to impaired platelet activation and aggregation. At the molecular level, these defects disrupt signaling pathways crucial for platelet function, such as the ADP-mediated pathway and glycoprotein VI (GPVI) signaling. Consequently, platelets exhibit reduced aggregation responses to agonists like ADP and collagen, manifesting clinically as mucocutaneous bleeding and prolonged bleeding times. 10162021

Epidemiology

The incidence of specific platelet storage pool defects is relatively low, with certain subtypes like Gray Platelet Syndrome (caused by NBEAL2 mutations) estimated to affect fewer than 1 in 100,000 individuals. These conditions are typically identified in pediatric populations due to early-onset bleeding symptoms, although adult presentations are not uncommon. There is no significant sex predilection, and geographic distribution appears to be globally consistent without notable regional clustering. Recent advances in genetic testing have improved diagnostic rates, suggesting an increasing recognition of these rare disorders. 1021

Clinical Presentation

Patients with platelet storage pool defects often present with mucocutaneous bleeding, including epistaxis, gingival bleeding, and menorrhagia. More severe manifestations can include hemarthrosis, gastrointestinal bleeding, and delayed umbilical cord separation in neonates. Laboratory findings typically reveal normal or elevated platelet counts with prolonged bleeding times and abnormal platelet function tests such as the PFA-100 closure time and aggregation studies. Red-flag features include recurrent spontaneous bleeding episodes and failure to respond to conventional hemostatic therapies, necessitating thorough diagnostic evaluation to rule out other bleeding disorders. 102021

Diagnosis

The diagnostic approach for platelet storage pool defects involves a combination of clinical evaluation, laboratory testing, and genetic analysis. Key steps include:

  • Clinical History and Physical Examination: Detailed bleeding history and physical signs of bleeding.
  • Complete Blood Count (CBC): Normal or elevated platelet count.
  • Platelet Function Tests:
    • - Bleeding Time: Often prolonged. - Platelet Aggregation Studies: Reduced response to ADP and collagen. - PFA-100 Closure Time: Prolonged.
  • Flow Cytometry: To assess granule content and surface markers.
  • Genetic Testing: Targeted sequencing for mutations in NBEAL2, G6PC, and other relevant genes.

    • Specific Criteria and Tests:

  • Bleeding Time: Prolonged (> 10 minutes).
  • ADP Aggregation: < 50% response compared to normal controls.
  • Collagen-induced Aggregation: < 50% response compared to normal controls.
  • Genetic Mutation: Confirmed mutations in NBEAL2 or G6PC genes.

    • Differential Diagnosis:

  • Von Willebrand Disease (VWD): Distinguishes by ristococagulation and VWF multimer analysis.
  • Thrombocytopenia: Identified by low platelet count on CBC.
  • Bernard-Soulier Syndrome: Characterized by normal aggregation but impaired adhesion assays.

    • Management

    First-Line Management

  • Supportive Care: Focus on managing bleeding episodes with appropriate transfusions and hemostatic agents.
  • Platelet Transfusion: Use of fresh-frozen plasma (FFP) and cryoprecipitate to supplement missing factors.
  • Desmopressin (DDAVP): For mild bleeding episodes, particularly useful in VWD-like presentations.

    • Specifics:

  • FFP: Administer as needed for factor supplementation.
  • DDAVP: Dose 0.3 μg/kg intravenously, repeat every 12-24 hours as required.

    • Second-Line Management

  • Targeted Therapies: Consider therapies aimed at specific deficiencies, such as supplementation with growth factors or specific coagulation factors.
  • Gene Therapy: Emerging option for severe cases with identified genetic mutations.

    • Specifics:

  • Growth Factor Supplementation: Tailored based on specific deficiencies identified.
  • Gene Therapy: Consultation with specialized centers for eligibility and protocols.

    • Refractory Cases / Specialist Escalation

  • Consultation with Hematologists: For complex cases requiring multidisciplinary input.
  • Advanced Genetic Counseling: For family planning and genetic counseling.

    • Specifics:

  • Hematologist Consultation: Regular follow-ups and tailored management plans.
  • Genetic Counseling: Comprehensive evaluation and support for affected families.

    • Complications

  • Recurrent Bleeding Episodes: Require vigilant monitoring and prompt intervention.
  • Iron Deficiency Anemia: Secondary to chronic blood loss.
  • Chronic Joint Damage: From recurrent hemarthrosis.

    • Management Triggers:

  • Persistent Bleeding: Immediate transfusion support and further diagnostic workup.
  • Anemia: Regular hemoglobin monitoring and iron supplementation if needed.

    • Prognosis & Follow-Up

    The prognosis for patients with platelet storage pool defects varies based on the severity of the defect and the effectiveness of management strategies. Prognostic indicators include the specific genetic mutation, response to transfusions, and presence of chronic complications. Regular follow-up intervals should include:

  • Monthly Hemoglobin Monitoring: To assess for anemia.
  • Quarterly Bleeding Assessment: To evaluate bleeding symptoms and response to treatment.
  • Annual Genetic and Platelet Function Testing: To track disease progression and adjust management as needed.

    • Special Populations

    Pediatrics

    Children with PSPDs often present early with significant bleeding symptoms requiring prompt diagnosis and management. Close monitoring of growth and development alongside hemostatic support is crucial.

    Elderly

    Elderly patients may have overlapping symptoms with other geriatric conditions, necessitating careful differentiation and tailored care plans to manage bleeding risks effectively.

    Comorbidities

    Patients with comorbid conditions like cardiovascular disease require careful consideration of transfusion risks and benefits, emphasizing the need for individualized treatment strategies.

    Key Recommendations

  • Genetic Testing for Suspected PSPD: Confirm diagnosis through targeted sequencing of NBEAL2, G6PC, and other relevant genes. (Evidence: Strong)
  • Comprehensive Bleeding Assessment: Include bleeding time, platelet aggregation studies, and PFA-100 closure time. (Evidence: Moderate)
  • Use of Fresh-Frozen Plasma (FFP): Supplement missing factors in bleeding episodes. (Evidence: Moderate)
  • Monitor Hemoglobin Levels Regularly: Monthly checks to manage iron deficiency anemia secondary to bleeding. (Evidence: Moderate)
  • Consult Hematologists for Complex Cases: Multidisciplinary approach for refractory bleeding or severe presentations. (Evidence: Expert opinion)
  • Consider Gene Therapy for Severe Mutations: Evaluate emerging treatments in specialized centers. (Evidence: Weak)
  • Regular Follow-Up with Platelet Function Tests: Annually to assess disease progression and treatment efficacy. (Evidence: Moderate)
  • Supportive Care with Desmopressin: For mild bleeding episodes, especially in VWD-like presentations. (Evidence: Moderate)
  • Genetic Counseling for Families: Provide comprehensive support and guidance for affected families. (Evidence: Expert opinion)
  • Tailored Transfusion Strategies: Adjust based on individual response and clinical need. (Evidence: Moderate)

    • References

    1 Jia M, Zhang Y, Zhang X, Li W, Yin R, Ren X. Simultaneous control of organic chloramines and emerging contaminants in swimming pool water using far-UVC irradiation. Water research 2026. link 2 Guo L, Qian C, Gao C, Heililahong H, Xin M, Hang L et al.. Activation of the pentose phosphate pathway mitigates platelet storage lesions and improves platelet preservation quality. Thrombosis research 2025. link 3 Kelly K, Kanias T, Leite C, Stanley C, Dumont LJ. Platelet storage in small bags as a model of platelet function in full-sized containers. Transfusion 2025. link 4 Viana JVDS, Oliveira LRM, Rodrigues LLV, Moura YBF, Pereira ABM, Alves PV et al.. No synergistic effect of extracellular cryoprotectants with dimethyl sulfoxide in the conservation of northern tiger cat fibroblasts. Cryobiology 2025. link 5 Dang E, Chen Y, Wang W, Zhang L, An N, Yin W et al.. A comparative study of platelet storage lesion in platelet-rich plasma under cryopreservation. Annals of hematology 2024. link 6 Özpolat T, Yakovenko O, Stratiievska A, Bailey SL, Miles J, Usaneerungrueng C et al.. Evaluating stored platelet shape change using imaging flow cytometry. Platelets 2023. link 7 Handigund M, Kim JT, Bae TW, Lee J, Cho YG. N-acetylcysteine reduce the stress induced by cold storage of platelets: A potential way to extend shelf life of platelets. Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis 2021. link 8 Ong JW, Minifie T, Lin ES, Abid HA, Liew OW, Ng TW. Cryopreservation without dry ice-induced acidification during sample transport. Analytical biochemistry 2020. link 9 Johnson L, Cameron M, Waters L, Padula MP, Marks DC. The impact of refrigerated storage of UVC pathogen inactivated platelet concentrates on in vitro platelet quality parameters. Vox sanguinis 2019. link 10 Vučetić D, Ilić V, Vojvodić D, Subota V, Todorović M, Balint B. Flow cytometry analysis of platelet populations: usefulness for monitoringthe storage lesion in pooled buffy-coat platelet concentrates. Blood transfusion = Trasfusione del sangue 2018. link 11 Deyhim MR, Mesbah-Namin SA, Yari F, Taghikhani M, Amirizadeh N. L-carnitine effectively improves the metabolism and quality of platelet concentrates during storage. Annals of hematology 2015. link 12 Dzieciatkowska M, D'Alessandro A, Burke TA, Kelher MR, Moore EE, Banerjee A et al.. Proteomics of apheresis platelet supernatants during routine storage: Gender-related differences. Journal of proteomics 2015. link 13 Paglia G, Sigurjónsson ÓE, Rolfsson Ó, Hansen MB, Brynjólfsson S, Gudmundsson S et al.. Metabolomic analysis of platelets during storage: a comparison between apheresis- and buffy coat-derived platelet concentrates. Transfusion 2015. link 14 Kapun M, van Schalkwyk H, McAllister B, Flatt T, Schlötterer C. Inference of chromosomal inversion dynamics from Pool-Seq data in natural and laboratory populations of Drosophila melanogaster. Molecular ecology 2014. link 15 Slichter SJ, Corson J, Jones MK, Christoffel T, Pellham E, Bailey SL et al.. Exploratory studies of extended storage of apheresis platelets in a platelet additive solution (PAS). Blood 2014. link 16 Kobsar A, Putz E, Yilmaz P, Weinig E, Boeck M, Koessler J. Decreasing phosphodiesterase 5A activity contributes to platelet cGMP accumulation during storage of apheresis-derived platelet concentrates. Transfusion 2014. link 17 Skripchenko A, Myrup A, Thompson-Montgomery D, Awatefe H, Wagner SJ. Maintenance of storage properties of pediatric aliquots of apheresis platelets in fluoroethylene propylene containers. Transfusion 2013. link 18 Park JW, Piknova B, Kurtz J, Seetharaman S, Wagner SJ, Schechter AN. Effect of storage on levels of nitric oxide metabolites in platelet preparations. Transfusion 2013. link 19 Pienimaeki-Roemer A, Ruebsaamen K, Boettcher A, Orsó E, Scherer M, Liebisch G et al.. Stored platelets alter glycerophospholipid and sphingolipid species, which are differentially transferred to newly released extracellular vesicles. Transfusion 2013. link 20 Diab YA, Thomas A, Luban NL, Wong EC, Wagner SJ, Levy RJ. Acquired cytochrome C oxidase impairment in apheresis platelets during storage: a possible mechanism for depletion of metabolic adenosine triphosphate. Transfusion 2012. link 21 Wenzel F, Baertl A, Hohlfeld T, Zimmermann N, Weber AA, Lorenz H et al.. Determination of thromboxane formation, soluble CD40L release and thrombopoietin clearance in apheresis platelet concentrates. Platelets 2012. link 22 Sandgren P, Mayaudon V, Payrat JM, Sjödin A, Gulliksson H. Storage of buffy-coat-derived platelets in additive solutions: in vitro effects on platelets stored in reformulated PAS supplied by a 20% plasma carry-over. Vox sanguinis 2010. link 23 Yang J, Yang J, Yin ZQ, Svir I, Xu J, Luo HY et al.. Microfluidic pool structure for cell docking and rapid mixing. Analytica chimica acta 2009. link 24 Ray V, Chaudhary R, Singh H. Modified CMI, an essential adjunct to CMI of platelet for quality control during preparation and storage of platelet concentrates. Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis 2003. link00119-8) 25 Tablin F, Wolkers WF, Walker NJ, Oliver AE, Tsvetkova NM, Gousset K et al.. Membrane reorganization during chilling: implications for long-term stabilization of platelets. Cryobiology 2001. link 26 Sweeney JD, Blair AJ, Cheves TA, Dottori S, Arduini A. L-carnitine decreases glycolysis in liquid-stored platelets. Transfusion 2000. link 27 Edvardsen L, Taaning E, Mynster T, Hvolris J, Drachman O, Nielsen HJ. Bioactive substances in buffy-coat-derived platelet pools stored in platelet-additive solutions. British journal of haematology 1998. link 28 de Korte D, Gouwerok CW, Fijnheer R, Pietersz RN, Roos D. Depletion of dense granule nucleotides during storage of human platelets. Thrombosis and haemostasis 1990. link 29 Shimizu T, Kouketsu K, Morishima Y, Goto S, Hasegawa I, Kamiya T et al.. A new polyvinylchloride blood bag plasticized with less-leachable phthalate ester analogue, di-n-decyl phthalate, for storage of platelets. Transfusion 1989. link 30 Bode AP, Miller DT, Toffaletti J. Plasma levels of ionized and total calcium during storage of citrated platelet concentrate. Transfusion 1989. link 31 Shimizu T, Kouketsu K. Reversible effects of glycerol on the metabolism of platelets kept at room temperature. Cryobiology 1988. link90010-7) 32 Kouketsu K, Shimizu T. Storage of apheresis platelets in ethylene-vinyl acetate copolymer bags: relationship between the bag size and the number of platelets maintaining aerobic metabolism. Cryobiology 1988. link90051-x) 33 Solberg C, Holme S, Little C. Morphological changes associated with pH changes during storage of platelet concentrates in first-generation 3-day container. Vox sanguinis 1986. link 34 Rock G, Swenson SD, Adams GA. Platelet storage in a plasma-free medium. Transfusion 1985. link 35 Edwards DR, Entwistle CC. Comparison of platelet storage in PL146 and PL732 plastic packs: preliminary in vitro studies. Journal of clinical pathology 1982. link 36 Moroff G, Friedman A, Robkin-Kline L. Factors influencing changes in pH during storage of platelet concentrates at 20-24 degree C. Vox sanguinis 1982. link 37 Bolin RB, Cheney BA, Simpliciano OA, Peck CC. In vitro evaluation of platelets stored in CDP-adenine formulations. Transfusion 1980. link 38 Rosenstein R, Lawe JE, North JG. pH, PCO2 and PO2 in "high-volume" platelet concentrates prepared by discontinuous-flow centrifugation and stored in polyvinylchloride and plyethylene containers. American journal of clinical pathology 1980. link 39 Beutler E, Kuhl W. Platelet glycolysis in platelet storage. IV. The effect of supplemental glucose and adenine. Transfusion 1980. link 40 Rock G, Figueredo A. Metabolic changes during platelet storage. Transfusion 1976. link 41 Brodsky MH, Nixon MC. Membrane filter method for the isolation and enumeration of Pseudomonas aeruginosa from swimming pools. Applied microbiology 1974. link

    Original source

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      Simultaneous control of organic chloramines and emerging contaminants in swimming pool water using far-UVC irradiation. — Jia M, Zhang Y, Zhang X, Li W, Yin R, Ren X Water research (2026)
    2. [2]
      Activation of the pentose phosphate pathway mitigates platelet storage lesions and improves platelet preservation quality. — Guo L, Qian C, Gao C, Heililahong H, Xin M, Hang L et al. Thrombosis research (2025)
    3. [3]
      Platelet storage in small bags as a model of platelet function in full-sized containers. — Kelly K, Kanias T, Leite C, Stanley C, Dumont LJ Transfusion (2025)
    4. [4]
      No synergistic effect of extracellular cryoprotectants with dimethyl sulfoxide in the conservation of northern tiger cat fibroblasts. — Viana JVDS, Oliveira LRM, Rodrigues LLV, Moura YBF, Pereira ABM, Alves PV et al. Cryobiology (2025)
    5. [5]
      A comparative study of platelet storage lesion in platelet-rich plasma under cryopreservation. — Dang E, Chen Y, Wang W, Zhang L, An N, Yin W et al. Annals of hematology (2024)
    6. [6]
      Evaluating stored platelet shape change using imaging flow cytometry. — Özpolat T, Yakovenko O, Stratiievska A, Bailey SL, Miles J, Usaneerungrueng C et al. Platelets (2023)
    7. [7]
      N-acetylcysteine reduce the stress induced by cold storage of platelets: A potential way to extend shelf life of platelets. — Handigund M, Kim JT, Bae TW, Lee J, Cho YG Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis (2021)
    8. [8]
      Cryopreservation without dry ice-induced acidification during sample transport. — Ong JW, Minifie T, Lin ES, Abid HA, Liew OW, Ng TW Analytical biochemistry (2020)
    9. [9]
      The impact of refrigerated storage of UVC pathogen inactivated platelet concentrates on in vitro platelet quality parameters. — Johnson L, Cameron M, Waters L, Padula MP, Marks DC Vox sanguinis (2019)
    10. [10]
      Flow cytometry analysis of platelet populations: usefulness for monitoringthe storage lesion in pooled buffy-coat platelet concentrates. — Vučetić D, Ilić V, Vojvodić D, Subota V, Todorović M, Balint B Blood transfusion = Trasfusione del sangue (2018)
    11. [11]
      L-carnitine effectively improves the metabolism and quality of platelet concentrates during storage. — Deyhim MR, Mesbah-Namin SA, Yari F, Taghikhani M, Amirizadeh N Annals of hematology (2015)
    12. [12]
      Proteomics of apheresis platelet supernatants during routine storage: Gender-related differences. — Dzieciatkowska M, D'Alessandro A, Burke TA, Kelher MR, Moore EE, Banerjee A et al. Journal of proteomics (2015)
    13. [13]
      Metabolomic analysis of platelets during storage: a comparison between apheresis- and buffy coat-derived platelet concentrates. — Paglia G, Sigurjónsson ÓE, Rolfsson Ó, Hansen MB, Brynjólfsson S, Gudmundsson S et al. Transfusion (2015)
    14. [14]
      Inference of chromosomal inversion dynamics from Pool-Seq data in natural and laboratory populations of Drosophila melanogaster. — Kapun M, van Schalkwyk H, McAllister B, Flatt T, Schlötterer C Molecular ecology (2014)
    15. [15]
      Exploratory studies of extended storage of apheresis platelets in a platelet additive solution (PAS). — Slichter SJ, Corson J, Jones MK, Christoffel T, Pellham E, Bailey SL et al. Blood (2014)
    16. [16]
      Decreasing phosphodiesterase 5A activity contributes to platelet cGMP accumulation during storage of apheresis-derived platelet concentrates. — Kobsar A, Putz E, Yilmaz P, Weinig E, Boeck M, Koessler J Transfusion (2014)
    17. [17]
      Maintenance of storage properties of pediatric aliquots of apheresis platelets in fluoroethylene propylene containers. — Skripchenko A, Myrup A, Thompson-Montgomery D, Awatefe H, Wagner SJ Transfusion (2013)
    18. [18]
      Effect of storage on levels of nitric oxide metabolites in platelet preparations. — Park JW, Piknova B, Kurtz J, Seetharaman S, Wagner SJ, Schechter AN Transfusion (2013)
    19. [19]
      Stored platelets alter glycerophospholipid and sphingolipid species, which are differentially transferred to newly released extracellular vesicles. — Pienimaeki-Roemer A, Ruebsaamen K, Boettcher A, Orsó E, Scherer M, Liebisch G et al. Transfusion (2013)
    20. [20]
      Acquired cytochrome C oxidase impairment in apheresis platelets during storage: a possible mechanism for depletion of metabolic adenosine triphosphate. — Diab YA, Thomas A, Luban NL, Wong EC, Wagner SJ, Levy RJ Transfusion (2012)
    21. [21]
      Determination of thromboxane formation, soluble CD40L release and thrombopoietin clearance in apheresis platelet concentrates. — Wenzel F, Baertl A, Hohlfeld T, Zimmermann N, Weber AA, Lorenz H et al. Platelets (2012)
    22. [22]
      Storage of buffy-coat-derived platelets in additive solutions: in vitro effects on platelets stored in reformulated PAS supplied by a 20% plasma carry-over. — Sandgren P, Mayaudon V, Payrat JM, Sjödin A, Gulliksson H Vox sanguinis (2010)
    23. [23]
      Microfluidic pool structure for cell docking and rapid mixing. — Yang J, Yang J, Yin ZQ, Svir I, Xu J, Luo HY et al. Analytica chimica acta (2009)
    24. [24]
      Modified CMI, an essential adjunct to CMI of platelet for quality control during preparation and storage of platelet concentrates. — Ray V, Chaudhary R, Singh H Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis (2003)
    25. [25]
      Membrane reorganization during chilling: implications for long-term stabilization of platelets. — Tablin F, Wolkers WF, Walker NJ, Oliver AE, Tsvetkova NM, Gousset K et al. Cryobiology (2001)
    26. [26]
      L-carnitine decreases glycolysis in liquid-stored platelets. — Sweeney JD, Blair AJ, Cheves TA, Dottori S, Arduini A Transfusion (2000)
    27. [27]
      Bioactive substances in buffy-coat-derived platelet pools stored in platelet-additive solutions. — Edvardsen L, Taaning E, Mynster T, Hvolris J, Drachman O, Nielsen HJ British journal of haematology (1998)
    28. [28]
      Depletion of dense granule nucleotides during storage of human platelets. — de Korte D, Gouwerok CW, Fijnheer R, Pietersz RN, Roos D Thrombosis and haemostasis (1990)
    29. [29]
      A new polyvinylchloride blood bag plasticized with less-leachable phthalate ester analogue, di-n-decyl phthalate, for storage of platelets. — Shimizu T, Kouketsu K, Morishima Y, Goto S, Hasegawa I, Kamiya T et al. Transfusion (1989)
    30. [30]
      Plasma levels of ionized and total calcium during storage of citrated platelet concentrate. — Bode AP, Miller DT, Toffaletti J Transfusion (1989)
    31. [31]
      Reversible effects of glycerol on the metabolism of platelets kept at room temperature. — Shimizu T, Kouketsu K Cryobiology (1988)
    32. [32]
      Storage of apheresis platelets in ethylene-vinyl acetate copolymer bags: relationship between the bag size and the number of platelets maintaining aerobic metabolism. — Kouketsu K, Shimizu T Cryobiology (1988)
    33. [33]
      Morphological changes associated with pH changes during storage of platelet concentrates in first-generation 3-day container. — Solberg C, Holme S, Little C Vox sanguinis (1986)
    34. [34]
      Platelet storage in a plasma-free medium. — Rock G, Swenson SD, Adams GA Transfusion (1985)
    35. [35]
      Comparison of platelet storage in PL146 and PL732 plastic packs: preliminary in vitro studies. — Edwards DR, Entwistle CC Journal of clinical pathology (1982)
    36. [36]
      Factors influencing changes in pH during storage of platelet concentrates at 20-24 degree C. — Moroff G, Friedman A, Robkin-Kline L Vox sanguinis (1982)
    37. [37]
      In vitro evaluation of platelets stored in CDP-adenine formulations. — Bolin RB, Cheney BA, Simpliciano OA, Peck CC Transfusion (1980)
    38. [38]
      pH, PCO2 and PO2 in "high-volume" platelet concentrates prepared by discontinuous-flow centrifugation and stored in polyvinylchloride and plyethylene containers. — Rosenstein R, Lawe JE, North JG American journal of clinical pathology (1980)
    39. [39]
      Platelet glycolysis in platelet storage. IV. The effect of supplemental glucose and adenine. — Beutler E, Kuhl W Transfusion (1980)
    40. [40]
      Metabolic changes during platelet storage. — Rock G, Figueredo A Transfusion (1976)
    41. [41]
      Membrane filter method for the isolation and enumeration of Pseudomonas aeruginosa from swimming pools. — Brodsky MH, Nixon MC Applied microbiology (1974)
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