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Flow cytometry for near-patient testing in premature neonates reveals variation in platelet function: a novel approach to guide platelet transfusion.

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Waller, Amie K 
Lantos, Lajos 
Sammut, Audrienne 
Salgin, Burak 
McKinney, Harriet 


BACKGROUND: Neonatal haemorrhaging is often co-observed with thrombocytopenia; however, no evidence of a causal relationship with low platelet count has been reported. Regardless, the administration of a platelet transfusion is often based upon this parameter. Accurate measurement of platelet function in small volumes of adult blood samples by flow cytometry is well established and we propose that the use of the same technology could provide complementary information to guide the administration of platelet transfusions in premature neonates. METHODS: In 28 neonates born at 27-41 weeks gestation, platelet function after stimulation agonists was measured using fibrinogen binding and P-selectin expression (a marker of degranulation). RESULTS: Platelets of neonates with gestation of ≤36 weeks (n = 20) showed reduced fibrinogen binding and degranulation with ADP, and reduced degranulation with CRP-XL. Degranulation Scores of 7837 ± 5548, 22,408 ± 5301 and 53,131 ± 12,102 (mean ± SEM) identified significant differences between three groups: <29, 29-36 and >36 weeks gestation). Fibrinogen binding and degranulation responses to ADP were significantly reduced in suspected septic neonates (n = 6) and the Fibrinogen Binding scores clearly separated the septic and healthy group (88.2 ± 10.3 vs 38.6 ± 12.2, P = 0.03). CONCLUSIONS: Flow cytometric measurement of platelet function identified clinically different neonatal groups and may eventually contribute to assessment of neonates requiring platelet transfusion.



Cell Degranulation, Female, Fibrinogen, Flow Cytometry, Hemorrhage, Humans, Infant, Newborn, Infant, Premature, Male, Neonatal Sepsis, P-Selectin, Platelet Activation, Platelet Count, Platelet Function Tests, Platelet Transfusion, Thrombocytopenia, Neonatal Alloimmune

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Pediatr Res

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Springer Science and Business Media LLC
Medical Research Council (MC_PC_12009)
This study was funded by the NHSBT through the Howard Ostin Fund - Dr Ghevaert will get this amended to include the core support from Wellcome and MRC to the Stem Cell Institute