Are Cold Storage Platelets Going to Replace Room Temperature Transfusions in Trauma Situations?

Are Cold Storage Platelets Going to Replace Room Temperature Transfusions in Trauma Situations?

In the 1970s, the cold storage of platelets was abandoned due to reduced circulation time. The FDA now only permits hospitals to store platelets for 5-7 days at room temperature. Consequently, room temperature platelets have become the clinical standard for all medical practices. Recently, there has been a renewed outlook for using cold stored platelets in trauma patients where massive blood loss has occurred.

Many studies have indicated that platelets offer clinical value when stored at 1° -6°C and may assist blood clotting. Because platelets are so important, expansive research is underway to understand the properties of platelets that might make them viable following long-term storage.

There is a Global Blood Shortage: Platelet Donations are in Urgent Demand

As of this writing, we are in dire need of blood donations, making the preservation of blood products vital. The coronavirus crippled blood drive efforts, and all blood supplies have been exhausted due to increased trauma-related circumstances around the globe.

The Red Cross indicates that every 15 seconds, someone will require a platelet transfusion. This translates to about 2 million units of platelets being transfused each year in the U.S.

Platelets Play a Vital Role in Saving Lives

Platelets, or thrombocytes, are small, colorless cell components contained in our blood that form clots and help to prevent excessive bleeding. They are made in our bone marrow, and when a signal is given, they rush to the site of the wound to begin the clotting process.

Did you know? The normal platelet count is 150,000-350,000 per microliter of blood, but since platelets are so small, they make up just a tiny fraction of the blood volume.

One of the main life-threatening conditions is a phenomenon known as Thrombosis. This occurs when your blood clots and blocks the flow of blood inside the blood vessel. There are two main types of thrombosis:

  • Venous thrombosis is when the blood clot blocks a vein. Veins carry blood from the body back into the heart.
  • Arterial thrombosis is when the blood clot blocks an artery.

You may have heard it referred to as DVT or Deep Vein Thrombosis. Statistics indicate the chances of developing DVT is approximately 1 in 1000 per year. The risk factors vary, but contributing factors include:

      • Age
      • Pregnancy
      • Prolonged Sitting
      • Smoking
      • Being Overweight
      • DVT History
      • Injury or Trauma

How deep vein thrombosis (DVT) forms

What Are the Challenges with Cold Storage of Platelets?

Since cold platelets can only be stored for three days, it makes it difficult for hospitals to keep a stocked supply. Other concerns for both room temperature or cold platelets (4°C) are contamination or adverse events following transfusion because of bacteria growth. There is a slight lean that cold storage paired with an additive may aid in this circumstance.

Cold-stored platelets become activated via a series of complex MOAs (mechanism of action). Certain morphological and molecular changes occur due to cold exposure enhance their ability to participate in the hemostatic process at the cost of rapid clearance from circulation.

Solutions may include both additives and aggregation prior to transfusion. The studies chronicled below indicate comparable results for both room temperature and CSPs. However, the insights provided by researchers indicate a strong potential for the adoption of CSPs in many clinical applications.

Clinical Studies of CSPs (Cold Storage Platelets)

In 2020, an investigative research group was awarded $26 million in funding for the cold storage of platelets efficacy. Their specific aim is to determine whether cold platelets can reduce blood loss more effectively than the traditional methodology using platelets stored at room temperature.

Research shows that cold platelets stored for up to 21 days may improve clotting function compared with room-temperature platelets stored for up to 5 to 7 days. Aging of platelets after in vitro storage at 22 degrees C is significantly slower than aging of platelets in vivo at 37 degrees C, a circumstance that may make the long-term storage of platelets a reality.

“Platelets are essential for saving the lives of patients with severe bleeding,” said the study’s co-principal investigator, Philip C. Spinella, MD, a director of the Pediatric Critical Care Translational Research Program and a professor of pediatrics at Washington University. “If we find a clotting benefit from cold storage, the findings from this trial with cardiac surgery patients also may be applied to patients who experience life-threatening excessive bleeding from other causes of severe bleeding such as traumatic injury, gastrointestinal problems or childbirth.”

The Future Outlook for the Use of Cold Storage Platelets

There is clear evidence that CSPs present certain advantages for wound healing and surgical interventions. Opportunities to preserve platelets for longer periods of time is an attractive study modality because the window for using RT (room temperature) platelets is so limited. Cryopreservation and long-term refrigeration might be in the near future, forcing many blood banks and hospitals to reevaluate their storage capacities.

K2 Scientific offers competitive pricing on all our FDA-compliant cold storage solutions. We look forward to partnering with our scientific partners. Learn more today.

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