Refrigeration, cryopreservation and pathogen inactivation: an updated perspective on platelet storage conditions

Abstract

Conventional storage of platelet concentrates limits their shelf life to between 5 and 7 days due to the risk of bacterial proliferation and the development of the platelet storage lesion. Cold storage and cryopreservation of platelets may facilitate extension of the shelf life to weeks and years, and may also provide the benefit of being more haemostatically effective than conventionally stored platelets. Further, treatment of platelet concentrates with pathogen inactivation systems reduces bacterial contamination and provides a safeguard against the risk of emerging and re-emerging pathogens. While each of these alternative storage techniques is gaining traction individually, little work has been done to examine the effect of combining treatments in an effort to further improve product safety and minimize wastage. This review aims to discuss the benefits of alternative storage techniques and how they may be combined to alleviate the problems associated with conventional platelet storage.

Non-ionizing 405 nm Light as a Potential Bactericidal Technology for Platelet Safety: Evaluation of in vitro Bacterial Inactivation and in vivo Platelet Recovery in Severe Combined Immunodeficient Mice

“…All four irradiances levels used in the study (3,5,7, and 10 mWcm −2 ) achieved good bactericidal effects, with consistent trends of inactivation rates: >92.5% reduction by 6 h, and >99% reduction by 8 h. Although there was, in the most part, no significant difference in the levels of inactivation achieved at each exposure time with the different irradiance levels, trends were observed. Use of 10 mWcm −2 light, resulted in the most linear inactivation kinetics, with inactivation at the lower irradiances (3, 5, 7 mWcm −2 ) displaying a more linear, and indeed upward, initial trend (up to 3-4 h) before inactivation became evident (∼5 h onwards).…”

“…Bacterially contaminated PLTs are associated with the highest risk of transfusion transmitted infection in the USA, and can lead to septic transfusion reactions (1,2). Platelet transfusion products are particularly susceptible to contamination due to their storage at 22 ± 2 • C in gas permeable bags, under constant agitation for 5-7 days post donation (3,4).…”

Pathogen inactivation with amotosalen plus UVA illumination minimally impacts microRNA expression in platelets during storage under standard blood banking conditions

“…The onset and accumulation of PSL is related to the activation of or damage to the platelets as result of their preparation or storage conditions, and can eventually lead to further effects. All aspects of platelet processing can contribute to platelet alterations, including collection, post collection manipulation, and storage . The majority of PCs are used as prophylaxis of bleeding in patients with low platelet count, e.g., as a result of bone marrow failure due to hematological malignancy and radio‐ or chemotherapy, a relatively frequent scenario in older populations …”

How do I get an emergency civilian walking blood bank running?

“…Otherwise, Thrombosomes ® (Cellphire), which are lyophilized platelet fragments, are under clinical evaluation and might serve as a viable option together with cryopreserved platelets. [18][19][20][21][22][23] The presented case illustrates that even a Norwegian level 1 trauma center with the second-largest integrated blood center in Norway, can be forced to trigger the mass casualty preparedness plan due to one single trauma patient. Transfusion of about 200 units of blood products in a short period of time is challenging when it comes to administration, and to keep record of the ratio between red cells, plasma, and platelets.…”

“…Cold storage of platelet concentrates might allow storage with preserved hemostatic function for 14–21 days. Otherwise, Thrombosomes® (Cellphire), which are lyophilized platelet fragments, are under clinical evaluation and might serve as a viable option together with cryopreserved platelets …”