Transfusion experience with platelet concentrates stored for 24 to 72 hours at 22° C

Abstract

We studied the transfusion response from random donor platelet concentrates in 15 stable multitransfused, thrombocytopenic patients by comparing the platelet counts measured before and 20 hours after transfusion. The observed platelet increments were corrected (corrected increment, C.I.) for the number of units of platelet concentrate transfused and the patient's body surface area in square meters (platelets/microliter per unit/m2). Using platelet concentrates stored for less than 24 hours, the patients achieved a median C.I. of 9500 (range: 5000-18,000). When platelet concentrates stored for 24 to 48 hours or 48 to 72 hours were given, the median C.I. markedly decreased to 1000 (range: 0-4800) and 0 (range: 0-5100), respectively (p less than 0.001). These differences could not be explained by further recipient alloimmunization. Transfusion with platelet concentrates less than 24 hours old on a second occasion, bracketing the transfusions of older platelet concentrates, resulted in a median C.I. of 7200 (range: 5400-14,500). Similar results were obtained in three patients when HLA-identical sibling platelet concentrates were employed. In vitro tests, including pH, morphology, and aggregation, demonstrated no statistically significant differences among the platelet concentrates stored for less than 24 hours, 24 to 48 hours, and 48 to 72 hours. These studies suggest that, although platelet concentrates can be stored for 72 hours without loss of in vitro function, the in vivo recovery is significantly diminished after 24 hours of storage, and preferably patients should not be transfused prophylactically with platelet concentrates greater than 24 hours old.

Transfusion Results of Filtered and Subsequently Stored Random Platelet Suspensions Prepared from Buffy Coats

“…However, as already described by others [27,28] in non-filtered platelet sus pensions. we noticed a storage time-related decrease in CCIs.…”

Binding of activated platelets to WBCs in vivo after transfusion

“…CCI after the transfusion of PCs stored for 1 to 2 days were higher than those stored for 3 to 5 days. 47‐49 Murphy et al 50 and Holme et al 51 showed that the in vivo recovery of stored platelets was reduced. A deterioration of in vivo hemostatic efficacy has been demonstrated by other groups.…”

Factors affecting posttransfusion platelet increments, platelet refractoriness, and platelet transfusion intervals in thrombocytopenic patients

“…Longer platelet storage times have been reported to decrease posttransfusion platelet viability. [20][21][22][23] However, some investigators have suggested that storage adversely affects only platelet concentrates rather than apheresis platelets. 24 In our study, an equal benefit of platelets stored for 48 hours or less was seen for all the types of platelets transfused.…”