The Use of Frozen Platelets for the Treatment of Bleeding

Kleinveld, Derek J. B.; Juffermans, Nicole P.; Noorman, Femke

doi:10.1007/978-3-030-37323-8_26

Cited by 4 publications

(6 citation statements)

References 49 publications

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“…An animal study including rats with traumatic haemorrhage who were subsequently transfused with DTC showed reduced blood component use compared to RSP to reach and maintain a mean arterial pressure of 60 mmHg. (11) (12) In thrombocytopenic patients the use of cryopreserved platelets appears to be safe and effective and also in trauma (12), cardiopulmonary surgery (9) (17) or thrombocytopenia (10) (14) the outcome of treatment with frozen platelets was similar to room stored platelet transfusion. Despite this fact, high quality evidence from randomised clinical trials for the e cacy of DTC in acute bleeding is still lacking.…”

Section: Discussionmentioning

confidence: 99%

“…(8-10) These differences are likely due to platelet activation and release of platelet derived micro particles after thaw. (11) The use of DTCs in several clinical studies has not led to effectivity or safety issues in trauma (12), thrombocytopenic (11,13) or cardiopulmonary bypass (9) patients and in in rats. (12) In the current introduced multi-centre, single blinded, randomized controlled non-inferiority trial, the objective is to compare the haemostatic effects of DTCs with the currently predominantly used RSPs in the treatment of surgical bleeding and to show that DTCs have at least similar haemostatic effects as compared to RSP.…”

mentioning

confidence: 99%

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The haemostatic effect of deep-frozen platelets versus room temperature stored platelets in the treatment of surgical bleeding. MAFOD: study protocol for a randomized controlled non-inferiority trial

Rijnhout

Noorman

Horst

et al. 2022

Preprint

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Background : The Netherlands Armed Forces have been successfully using deep frozen (-80°C) thrombocyte concentrate (DTC) for the treatment of (massive) bleeding trauma patients in austere environments since 2001. However, high-quality evidence for effectiveness and safety of DTCs is currently lacking. Therefore, the MAssive transfusion of Frozen bloOD (MAFOD) trial is designed to compare the haemostatic effect of DTCs versus room temperature stored platelets (RSP) in the treatment of surgical bleeding. Methods : The MAFOD trial is a single-blinded, randomized controlled non-inferiority trial and will be conducted in three level 1 trauma centres in the Netherlands. Patients of 12 years or older, alive at hospital presentation, requiring a massive transfusion including platelets, and with signed (deferred) consent will be included. The primary outcome is the percentage of patients that have achieved haemostasis within six hours and show signs of life. Haemostasis is defined as the time in minutes from arrival to the time of the last blood component transfusion (plasma/platelets or red blood cells), followed by a two-hour transfusion free period. This is the first randomized controlled study investigating DTCs in trauma- and vascular surgical bleeding. Discussion: The hypothesis is that the percentage of patients that will achieve haemostasis in the DTC group is at least equal to the RSP group (85%). With a power of 80%, a significance level of 5% and a non-inferiority limit of 15%, a total of 71 patients in each arm are required. Thus, resulting in a total of 158 patients, including a 10% refusal rate. The data collected during the study could help improve the use of platelets during resuscitation management. If proven non-inferior in civilian setting, frozen platelets may be used in the future to optimize logistics and improve platelet availability in rural or remote areas for the treatment of (massive) bleeding trauma patients in civilian settings. Trial registration: ClinicalTrials.gov NCT05502809. Registered on 16 August 2022. Keywords : Transfusion; cryopreservation; trauma; bleeding; haemorrhage; platelets; resuscitation; injury; blood; coagulopathy

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The haemostatic effect of deep-frozen platelets versus room temperature stored platelets in the treatment of surgical bleeding. MAFOD: study protocol for a randomized controlled non-inferiority trial

Rijnhout

Noorman

Horst

et al. 2022

Preprint

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“…The NLAF have been using DTC for the past 20 years. An animal study including rats with traumatic haemorrhage who were subsequently transfused with DTC showed reduced blood component use compared to RSP to reach and maintain a mean arterial pressure of 60 mmHg [ 11 , 12 ]. In thrombocytopenic patients, the use of cryopreserved platelets appears to be safe and effective, and also in trauma [ 12 ], cardiopulmonary surgery [ 9 ] or thrombocytopenia [ 10 , 14 ], the outcome of treatment with frozen platelets was similar to room-stored platelet transfusion.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, DTCs show impaired aggregation in classic aggregation tests and clot strength but accelerated clot formation and thrombin formation as compared to other platelet products [ 8 – 10 ]. These differences are likely due to platelet activation and release of platelet-derived microparticles after the thaw [ 11 ]. The use of DTCs in several clinical studies has not led to effectivity or safety issues in trauma [ 12 ], thrombocytopenic [ 11 , 13 ] or cardiopulmonary bypass [ 9 ] patients and in rats [ 12 ].…”

Section: Background and Rationalementioning

confidence: 99%

“…These differences are likely due to platelet activation and release of platelet-derived microparticles after the thaw [ 11 ]. The use of DTCs in several clinical studies has not led to effectivity or safety issues in trauma [ 12 ], thrombocytopenic [ 11 , 13 ] or cardiopulmonary bypass [ 9 ] patients and in rats [ 12 ]. In the currently introduced multi-centre, single-blinded, randomized controlled non-inferiority trial, the objective is to compare the haemostatic effects of DTCs with the currently predominantly used RSPs in the treatment of surgical bleeding and to show that DTCs have at least similar haemostatic effects as compared to RSP.…”

Section: Background and Rationalementioning

confidence: 99%

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The haemostatic effect of deep-frozen platelets versus room temperature-stored platelets in the treatment of surgical bleeding: MAFOD—study protocol for a randomized controlled non-inferiority trial

Rijnhout

Noorman

Horst

et al. 2022

Trials

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Background The Netherlands Armed Forces have been successfully using deep-frozen (− 80 °C) thrombocyte concentrate (DTC) for the treatment of (massive) bleeding trauma patients in austere environments since 2001. However, high-quality evidence for the effectiveness and safety of DTCs is currently lacking. Therefore, the MAssive transfusion of Frozen bloOD (MAFOD) trial is designed to compare the haemostatic effect of DTCs versus room temperature-stored platelets (RSP) in the treatment of surgical bleeding. Methods The MAFOD trial is a single-blinded, randomized controlled non-inferiority trial and will be conducted in three level 1 trauma centres in The Netherlands. Patients 12 years or older, alive at hospital presentation, requiring a massive transfusion including platelets and with signed (deferred) consent will be included. The primary outcome is the percentage of patients that have achieved haemostasis within 6 h and show signs of life. Haemostasis is defined as the time in minutes from arrival to the time of the last blood component transfusion (plasma/platelets or red blood cells), followed by a 2-h transfusion-free period. This is the first randomized controlled study investigating DTCs in trauma and vascular surgical bleeding. Discussion The hypothesis is that the percentage of patients that will achieve haemostasis in the DTC group is at least equal to the RSP group (85%). With a power of 80%, a significance level of 5% and a non-inferiority limit of 15%, a total of 71 patients in each arm are required, thus resulting in a total of 158 patients, including a 10% refusal rate. The data collected during the study could help improve the use of platelets during resuscitation management. If proven non-inferior in civilian settings, frozen platelets may be used in the future to optimize logistics and improve platelet availability in rural or remote areas for the treatment of (massive) bleeding trauma patients in civilian settings. Trial registration ClinicalTrials.gov NCT05502809. Registered on 16 August 2022.

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State of the art in assisted reproductive technologies for patients with advanced maternal age

Yurchuk

Petrushkо

Fuller

2023

Zygote

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Summary According to the World Health Organization, the female reproductive age lasts up to 49 years, but problems with the realization of women’s reproductive rights may arise much earlier. Significant numbers of factors affect the state of reproductive health: socioeconomic, ecological, lifestyle features, the level of medical literacy, and the state of the organization and medical care quality. Among the reasons for fertility decline in advanced reproductive age are the loss of cellular receptors for gonadotropins, an increase in the threshold of sensitivity of the hypothalamic-pituitary system to the action of hormones and their metabolites, and many others. Furthermore, negative changes accumulate in the oocyte genome, reducing the possibility of fertilization, normal development and implantation of the embryo and healthy offspring birth. Another theory of ageing causing changes in oocytes is the mitochondrial free radical theory of ageing. Taking into account all these age-related changes in gametogenesis, this review considers modern technologies aimed at the preservation and realization of female fertility. Among the existing approaches, two main ones can be distinguished: methods allowing the preservation of reproductive cells at a younger age using ART intervention and cryobanking, as well as methods aimed at improving the basic functional state of advanced-age women’s oocytes and embryos.

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The Use of Frozen Platelets for the Treatment of Bleeding

Cited by 4 publications

References 49 publications

The haemostatic effect of deep-frozen platelets versus room temperature stored platelets in the treatment of surgical bleeding. MAFOD: study protocol for a randomized controlled non-inferiority trial

The haemostatic effect of deep-frozen platelets versus room temperature stored platelets in the treatment of surgical bleeding. MAFOD: study protocol for a randomized controlled non-inferiority trial

The haemostatic effect of deep-frozen platelets versus room temperature-stored platelets in the treatment of surgical bleeding: MAFOD—study protocol for a randomized controlled non-inferiority trial

State of the art in assisted reproductive technologies for patients with advanced maternal age

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