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Whole blood haemostatic function throughout a 28‐day cold storage period: an in vitro study
Author(s) -
McRae Hannah L.,
Kara Ferhat,
Milito Chelsea,
Cahill Christine,
Blumberg Neil,
Refaai Majed A.
Publication year - 2021
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/vox.13005
Subject(s) - medicine , thromboelastography , cold storage , whole blood , hemostasis , blood preservation , platelet , anesthesia , blood transfusion , epinephrine , surgery , andrology , biology , horticulture
Background In recent years, there has been renewed interest in whole blood (WB) transfusion, particularly in damage control resuscitation, in part due to the ability to provide the adequate ratio of blood components in a single transfusion. However, there is insufficient evidence to suggest that WB units maintain their haemostatic function during storage, which could compromise their quality and efficacy if transfused. Here, we evaluate the in vitro haemostatic function of stored WB units over a 28‐day refrigeration period. Methods Standard WB units were collected from healthy volunteers and stored at 4°C for 28 days. Samples were collected from each unit on several days throughout the storage period and tested for complete blood count (CBC), WB aggregation, clot kinetics as measured by thromboelastography (TEG), closure time and plasma‐free haemoglobin. Results Throughout the storage period, there were gradual, significant decreases in platelet count and function, including WB aggregation in response to collagen ( P < 0·05) and closure time with epinephrine ( P < 0·0005). Plasma‐free haemoglobin increased substantially (by 163%) throughout the storage period. However, TEG results remained relatively stable for 3 weeks, indicating possible preservation of haemostatic function during that time. Conclusion This study shows that clot kinetics (as measured by TEG) in WB units stored at 4°C are preserved for up to 21 days. However, high levels of free haemoglobin raise concern for the potential risks of transfusing stored WB. Clinical studies are required to evaluate optimal storage times and outcomes of patients resuscitated with WB as compared to blood components.