Good hemostatic effect of platelets stored at 4°C in an in vitro model of massive blood loss and thrombocytopenia

Abstract

This study compared the corrective effects of storage of platelets at 4°C and at 22°C in an in vitro model of massive blood loss and thrombocytopenia to provide an experimental basis for the storage of platelets for clinical applications. In vitro model of massive blood loss and thrombocytopenia were constructed by the in vitro hemodilution method and cell washing method. Using storage of platelets at 4°C (1, 3, 5, 7, 10, 14 days) and at 22°C (1, 3, 5 days) to correct the coagulation condition of the different models, by thromboelastography and by routine blood indices. ①Platelets stored at 4°C (1, 3, 5,7, 10, 14 days) and at 22°C (1, 3, 5 days) to correct the in vitro model of massive blood loss. Platelet count results improved from 17 to 27 × 10 9 /L to greater than 120 × 10 9 /L for 4°C storage, and 20 to 27 × 10 9 /L to greater than 120 × 10 9 /L for 22°C storage. Thromboelastography maximum amplitude (TEG-MA) results improved from 8.8 to 15.4 mm to greater than 43 mm for 4°C storage, and 12.2 to 14.4 mm to greater than 44.8 mm for 22°C storage. Thromboelastography reaction time values decreased from 9.9–24.9 minutes to 3.8–5.5 minutes for 4°C storage, and 9.9–22.7 minutes to 4.3–4.5 minutes for 22°C storage. ②Platelets stored at 4°C (1, 3, 5,7, 10, 14 days) and at 22°C (1, 3, 5 days) to correct the in vitro model of thrombocytopenia. Platelet count results improved from 12 to 34 × 10 9 /L to greater than 99 × 10 9 /L for 4°C storage, and 12 to 34 × 10 9 /L to greater than 120 × 10 9 /L for 22°C storage. TEG-MA results improved from 21.4 to 32.1 mm to greater than 49.1 mm for 4°C storage, and 21.4 to 31.6 mm to greater than 50.5 mm for 22°C storage. Platelets stored at 4°C and 22°C have the same correcting effect for 1, 3, and 5 days. Platelets stored at 4°C for 7 to 14 days have similarly hemostatic effect on the in vitro model of massive blood loss and thrombocytopenia.

Cold‐stored platelets have better preserved contractile function in comparison with room temperature‐stored platelets over 21 days

“…Alternatively, refrigeration of platelets at 4°C allows storage for up to 14 days yielding significantly higher metabolic reserves, agonist-induced functional responses in vitro, and clot strength compared to RTP. [11][12][13][14][15][16][17][18][19][20][21] Furthermore, these cold-stored platelets (CSP) are responsive to physiological inhibitors, 18,22 with in vivo bleeding correction times similar to fresh platelets. 11,20 In our previous efforts to investigate the mechanical and structural properties of clots formed from banked platelets, we reported that CSP formed clots with stiffness and strength comparable to fresh platelets, and that clots from RTP showed the effects of compromised contractile function on fibrin morphology.…”

“…Functional losses owing to the platelet storage lesion and increased risk of microbial contamination over time compromise platelet shelf life. Alternatively, refrigeration of platelets at 4°C allows storage for up to 14 days yielding significantly higher metabolic reserves, agonist‐induced functional responses in vitro, and clot strength compared to RTP 11–21 . Furthermore, these cold‐stored platelets (CSP) are responsive to physiological inhibitors, 18,22 with in vivo bleeding correction times similar to fresh platelets 11,20 …”

The clinical efficacy of 4℃ stored platelet: a randomized controlled feasibility trial conducted in surgical patients with related bleeding

“…(3) patients exhibiting platelet transfusion indications, including: massive blood loss(massive blood loss is replacement of the patient's total blood volume or transfusion of more than ten units of blood within 24 hours;A replacement of 50% of circulating blood volume in less than three hours or more than 150 ml per minute. ); platelet count ≤ 50×10 9…”