Assessment of the functional status of platelets for transfusion is confounded by the inherent complexity of the cell, as well as the intricate requirements of sample preparation. A correlation between discoid shape and the functional integrity of the platelet has been established. We have developed a complex automatic machine based on previous experiments with a simple prototype which measures the fraction of the platelets that are discoid and the optical (volume) concentration of unaggregated platelets in standard blood bank platelet concentrate units within their bags. The microprocessor-based instrument automatically determines the volume concentration of unaggregated platelets and the fraction that are fully viable (discoid) during a 3-minute measurement sequence following simple insertion of the blood storage bag in the instrument. This process is noninvasive (sterile) and nondestructive. Thus it allows frequent measurements on the platelets prior to transfusion in order to optimize the quality and quantity of transfused platelets given patients. It also allows accurate investigations for optimizing storage and preparation methods. The instrument has been intensively studied with respect to invasive measurements of concentration and morphology of platelets and has proved to be highly accurate. In order to test the clinical significance of these measurements, a clinical evaluation of the instrumentation has begun at the Blood Bank of the University of Virginia. Platelet reversible morphological changes in heating from 20 to 32degreesC have been discovered with the instrument and are being studied in order to better understand the relation between platelet in vitro and in vivo.
