Hemostatic properties of cold‐stored whole blood leukoreduced using a platelet‐sparing versus a non–platelet‐sparing filter

Haddaway, Kathy; Bloch, Evan M.; Tobian, Aaron A.R.; Frank, Steven M.; Sikorski, Robert; Cho, Brian; Zheng, Gang; Jani, Jayesh; Lokhandwala, Parvez M.; Lawrence, Courtney; Blagg, Lorraine; Ness, Paul M.; Kickler, Thomas S.; Gehrie, Eric A.

doi:10.1111/trf.15159

Cited by 29 publications

(41 citation statements)

References 32 publications

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“…Indeed, while originally PLTs were stored under refrigerated conditions, in the 1970's banking practices for this component started to change, owing to the appreciation that PLTs stored at room temperature would circulate longer in the bloodstream of the recipient . Transfusion of PLTs with longer circulation times are beneficial in the prevention of bleeding and reduce the frequency of prophylactic interventions based on PLT transfusion, thus mitigating the risk of alloimmunization in patients with hypoproliferative thrombocytopenia . On the other hand, storage at 20 to 24°C under constant agitation for 5 to 7 days increases the risk of bacterial growth, resulting in 1:5000 units at risk for bacterial contamination…”

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confidence: 99%

Metabolic phenotypes of standard and cold‐stored platelets

et al. 2019

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BACKGROUND Conventional platelet (PLT) storage at room temperature under continuous agitation results in a limited shelf life (5 days) and an increased risk of bacterial contamination. However, both of these aspects can be ameliorated by cold storage. Preliminary work has suggested that PLTs can be cold stored for up to 3 weeks, while preserving their metabolic activity longer than in PLTs stored at room temperature. As such, in the present study, we hypothesized that the metabolic phenotypes of PLTs stored at 4°C for 3 weeks could be comparable to that of room temperature–stored PLTs at 22°C for 5 days. Study Design and Methods Metabolomics analyses were performed on nine apheresis PLT concentrates stored either at room temperature (22°C) for 5 days or refrigerated conditions (4°C) for up to 3 weeks. RESULTS Refrigeration did not impact the rate of decline in glutamine or the intracellular levels of Krebs cycle metabolites upstream to fumarate and malate. It did, however, decrease oxidant stress (to glutathione and purines) and slowed down the activation of the pentose phosphate pathway, glycolysis, and fatty acid metabolism (acyl‐carnitines). CONCLUSION The overall metabolic phenotypes of 4°C PLTs at Storage Day 10 are comparable to PLTs stored at 22°C at the end of their 5‐day shelf life, while additional changes in glycolysis, purine, and fatty acid metabolism are noted by Day 21.

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Metabolic phenotypes of standard and cold‐stored platelets

et al. 2019

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“…38 Although the first comparative study of WB versus standard component therapy was proposed for civilian trauma resuscitation in 2009, 1 there are only a few retrospective comparative studies of CSWB with fixed ratio or standard resuscitation for urban civilian populations and only one randomized controlled trial (RCT) (►Table 2). The other published papers concerning the civilian use of WB for 12,28,[35][36][37] trauma are either editorials or descriptive papers on the feasibility and applicability of military far-forward WB use for trauma resuscitation generally. [3][4][5][6][7][30][31][32][40][41][42][43][44] These data-from a combined total of only 586 civilian patients-form the basis of recent widespread adoption of WB use in the United States prehospital and hospital environments in urban areas, with short transport times.…”

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confidence: 99%

“…These have been resolved since 2018 with the use of "low-titer" group O WB after the changes to the AABB standards in that year. 35 However, the viability of cold-stored platelets is more nuanced since studies of WB have demonstrated that platelet counts decline significantly in the first week of cold storage, even though platelet aggregation and thromboelastographic parameters remained stable. Furthermore, WB units have variability in hemostatic properties.…”

Section: Blood Banking Concerns and Costs Of Wb Transfusionmentioning

confidence: 99%

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Whole Blood for Civilian Urban Trauma Resuscitation: Historical, Present, and Future Considerations

Walsh

Fries

Moore

et al. 2020

Semin Thromb Hemost

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Whole blood (WB) has been used for more than a century for far-forward combat resuscitation. Following the Iraq/Afghanistan combat, maritime, and austere environment use of WB for the resuscitation of severely hemorrhaging patients, there has been an increasing use of WB for the civilian urban resuscitation environment population. The impetus for this was not just improved outcomes in far-forward hospitals, which had different populations and different needs than the civilian urban population, but also an application of the lessons suggested by recent 1:1:1 plasma:platelets:packed red cells fixed-ratio studies for patients with massive transfusion needs. Mechanistic, logistic, and standardization concerns have been addressed and are evolving as the WB project advances. A small number of studies have been published on WB in the civilian urban trauma population. In addition, European experience with viscoelastic testing and resuscitation with fibrinogen and prothrombin complex concentrate has provided another viewpoint regarding the choice of resuscitation strategies for severely bleeding trauma patients in urban civilian environments. There are randomized controlled trials in process, which are testing the hypothesis that WB may be beneficial for the civilian urban population. Whether WB will improve mortality significantly is now a matter of intense study, and this commentary reviews the history, mechanistic foundations, and logistical aspects for the use of WB in the civilian trauma population.

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“…Platelet aggregation in CWB evaluated by shear forces (PFA‐100) also maintained aggregation for 14 days when leucoreduced with platelet‐sparing methods but not when platelets were removed . Aggregation evaluated by agonist‐induced aggregation is reduced, but persistent, beyond day 10 .…”

Section: Functionality Of Platelets In Vitro and In Vivomentioning

confidence: 99%

Platelet functionality in cold‐stored whole blood

Kristoffersen

Apelseth

2019

ISBT Science Series

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Whole blood is currently being reintroduced as a blood product to be used in massive bleeding situations because it affords plasma, red cells and platelets in a balanced ratio and in a logistical advantageous way. Questions concerning the haemostatic potential of the platelets have arisen, especially in cold-stored whole blood, as this is the major whole blood product in use. When reviewing current knowledge on this, there is an abundance of publications demonstrating that in vitro, platelets in cold-stored whole blood have a haemostatic capacity up to 14 days, and even after 21 and 35 days of storage depending on type of additive solution. There is a paucity of data on clinical trials of cold-stored platelets, whereas there is an abundance of previous clinical experience with whole blood, both cold-stored and fresh, as an efficacious and safe product for use in pre-and in-hospital patients with life-threatening bleeding. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.CFWB, cold-stored fresh whole blood; CPD, citrate-phosphate-dextrose; CP2D, citrate-phosphate-double dextrose; CPDA-1, citrate-phosphate-dextroseadenine; CWB, cold-stored whole blood; WFWB, warm fresh whole blood. a Leucoreduction with platelet-sparing filter.

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Hemostatic properties of cold‐stored whole blood leukoreduced using a platelet‐sparing versus a non–platelet‐sparing filter

Cited by 29 publications

References 32 publications

Metabolic phenotypes of standard and cold‐stored platelets

Metabolic phenotypes of standard and cold‐stored platelets

Whole Blood for Civilian Urban Trauma Resuscitation: Historical, Present, and Future Considerations

Platelet functionality in cold‐stored whole blood

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