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Effects of storage time prolongation on in vivo and in vitro characteristics of 4°C–stored platelets
Author(s) -
Stolla Moritz,
Bailey S. Lawrence,
Fang Lydia,
Fitzpatrick Lynda,
Gettinger Irena,
Pellham Esther,
Christoffel Todd
Publication year - 2020
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.15669
Subject(s) - platelet , in vivo , apheresis , ex vivo , platelet transfusion , cold storage , bleeding time , in vitro , plateletpheresis , medicine , andrology , chemistry , immunology , biology , biochemistry , platelet aggregation , microbiology and biotechnology , horticulture
BACKGROUND Cold (4°C)‐stored platelets are currently under investigation for transfusion in bleeding patients. It is currently unknown how long cold‐stored platelets can be stored for clinical applications. STUDY DESIGN AND METHODS Twenty three subjects were recruited. Twenty‐one subjects were available for in vivo assessment and received indium‐111 radiolabeled, cold‐stored platelets. We investigated 5‐ (n = 5), 10‐ (n = 6), 15‐ (n = 5), and 20‐day–stored (n = 5) platelets and obtained samples for in vitro testing at baseline and after the designated storage time. Twenty three units were available for in vitro testing. Five‐ and 7‐day (n = 5 each), room temperature (RT)‐stored platelets served as the current clinical standard control. RESULTS In vivo, we found a continuous decline in platelet recovery from 5 to 20 days. Platelet survival reached a low nadir after 10 days of storage. Ex vivo, we observed the maximum platelet αIIbβ3 integrin response to collagen at 5 days of cold storage, and we saw a continuous decline thereafter. However, platelet integrin activation and mitochondrial membrane integrity were better preserved after 20 days at 4°C, compared to 5 days at RT. Platelet metabolic parameters suggest comparable results between 20‐day cold‐stored platelets and 5‐ or 7‐day RT‐stored platelets. CONCLUSION In summary, we performed the first studies with extended, cold‐stored, apheresis platelets in plasma for up to 20 days with a fresh comparator. Storing cold‐stored platelets up to 20 days yields better results in vitro, but further studies in actively bleeding patients are needed to determine the best compromise between hemostatic efficacy and storage prolongation.