Dried Platelets in a Swine Model of Liver Injury

Inaba, Kenji; Barmparas, Galinos; Rhee, Peter; Branco, Bernardino C.; Fitzpatrick, Michael; Okoye, Obi; Δημητριάδης, Δημήτριος

doi:10.1097/shk.0000000000000141

Cited by 21 publications

(14 citation statements)

References 24 publications

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“…However, porcine vWF has a high affinity for human platelet GPIb and will induce activation and aggregation of human platelets in the absence of agonists, so it is possible that the high prothrombotic complications are a result of poor xenotransplantation compatibility . In contrast, in a different swine model of nonsurgical bleeding there was poor hemostasis with the human pLP, possibly due to aggregation within the circulation before vascular injury localization, and no prothrombotic complications, while porcine pLP achieved superior hemostasis . These studies suggest that swine are a poor model for studying human platelets.…”

Section: Lyophilized Plateletsmentioning

confidence: 91%

Comprehensive review of platelet storage methods for use in the treatment of active hemorrhage

Milford

Reade

2016

Transfusion

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This review considers the various methods currently in use, or under investigation, for the storage of platelets intended for use in the treatment of active hemorrhage. The current standard practice of storing platelets at room temperature (RT) (20°C‐24°C) optimizes circulating time, but at the expense of hemostatic function and logistical considerations. A number of alternatives are under investigation. Novel storage media additives appear to attenuate the deleterious changes that affect RT stored platelets. Cold storage was originally abandoned due to the poor circulating time of platelets stored at 4°C, but such platelets may actually be more hemostatically effective, with a number of other advantages, compared to RT stored platelets. Periodically re‐warming cold stored platelets (temperature cycling, TC) may combine the hemostatic efficacy of cold stored platelets with the longer circulating times of RT storage. Alternatives to liquid storage include cryopreservation (freezing) or lyophilization (freeze‐drying). The former has had some limited clinical use and larger clinical trials are underway, while the latter is still in the preclinical stage with promising in vitro and in vivo results. The importance of platelet transfusion in the management of active hemorrhage is now well accepted, so it is timely that platelet storage methods are reviewed with consideration of not only their circulating time, but also their hemostatic efficacy.

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Section: Lyophilized Plateletsmentioning

confidence: 91%

Comprehensive review of platelet storage methods for use in the treatment of active hemorrhage

Milford

Reade

2016

Transfusion

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“…22 In a different swine model of hemorrhage, after removal of 35% blood volume with subsequent crystalloid resuscitation to achieve a 3:1 fluid-to-blood withdrawal resuscitation, pigs were injured in the left lobes of the liver with lacerations (1 Â 0.5 cm) that corresponded to two grids (5 Â 5 cm). 23 Animals were then transfused with either lyophilized human or porcine platelets in a dose equivalent to 5% of the preinjury platelet count. After 15 min of bleeding from hepatic injury, the abdomen was closed and animals were further resuscitated with crystalloid and subsequently euthanized 48 h after injury.…”

Section: Freeze-dried Blood Productsmentioning

confidence: 99%

“…There was no difference in mortality among the three groups, and histopathology of kidneys, lungs, and coronaries revealed no thrombi or emboli. 23 As no difference in blood loss or mortality was observed with lyophilized porcine platelet transfusion, this does not represent an option in the treatment of noncompressible torso hemorrhage.…”

Section: Freeze-dried Blood Productsmentioning

confidence: 99%

“…Freeze-dried platelets [21][22][23][24][25] Replaces platelets Largedpigs, monkeys Conflictingdsome studies showed benefit, whereas others did not Easy to administer Thrombi seen in some studies PEG nanospheres [26][27][28] Binds to activated platelets immediately after injury, but head-to-head comparison in terms of efficacy with platelets is needed. The TF-targeted nanofiber appears to moderately decrease blood loss; however, further testing, administration after injury in a larger animal model, and addition of a therapeutic are all needed to draw conclusions.…”

Section: Yesmentioning

confidence: 99%

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Emerging Therapies for Prehospital Control of Hemorrhage

Klein

Tsihlis

Pritts

et al. 2020

Journal of Surgical Research

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Background: The aim of this review was to describe emerging therapies that could serve as a prehospital intervention to slow or stop noncompressible torso hemorrhage in the civilian and military settings. Hemorrhage accounts for 90% of potentially survivable military deaths and 30%-40% of trauma deaths. There is a great need to develop novel therapies to slow or stop noncompressible torso hemorrhage at the scene of the injury. Methods: A comprehensive literature search was performed using PubMed (1966 to present) for therapies not approved by the Food and Drug Administration for noncompressible torso hemorrhage in the prehospital setting. Therapies were divided into compressive versus intravascular injectable therapies. Ease of administration, skill required to use the therapy, safety profile, stability, shelf-life, mortality benefit, and efficacy were reviewed. Results: Multiple potential therapies for noncompressible torso hemorrhage are currently under active investigation. These include (1) tamponade therapies, such as gas insufflation and polyurethane foam injection; (2) freeze-dried blood products and alternatives such as lyophilized platelets; (3) nanoscale injectable therapies such as polyethylene glycol nanospheres, polyethylenimine nanoparticles, SynthoPlate, and tissue factoretargeted nanofibers; and (4) other injectable therapies such as polySTAT and adenosine, lidocaine, and magnesium. Although each of these therapies shows great promise at slowing or stopping hemorrhage in animal models of noncompressible hemorrhage, further research is needed to ensure safety and efficacy in humans. Conclusions: Multiple novel therapies are currently under active investigation to slow or stop noncompressible torso hemorrhage in the prehospital setting and show promising results.

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“…Sending fresh supplies of liquid blood components to combat areas is logistically challenging [1], and it is not possible in the case of platelet concentrates (PCs) due to their short shelf life. While dried platelet products applicable in clinical practice are developed (still under investigation in animal models) [2,3], the medical military corps of several countries have started using integrated fresh-frozen blood banking, and now send red cell concentrates, fresh frozen plasma (FFP) and frozen platelets to combat areas [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

In vitro thromboelastometric evaluation of the efficacy of frozen platelet transfusion

Pérez-Ferrer

Suay

Viejo-Llorente

et al. 2015

Thrombosis Research

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Dried Platelets in a Swine Model of Liver Injury

Abstract: In this swine model of liver injury, human lyophilized platelets increased intraoperative blood loss. With the use of species-specific lyophilized platelets, however, this effect was abolished, with a decrease in blood loss at 48 h after injury.

Cited by 21 publications

References 24 publications

Comprehensive review of platelet storage methods for use in the treatment of active hemorrhage

Comprehensive review of platelet storage methods for use in the treatment of active hemorrhage

Emerging Therapies for Prehospital Control of Hemorrhage

In vitro thromboelastometric evaluation of the efficacy of frozen platelet transfusion

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