Platelet Storage Alternatives

Objective:

This survey aims to understand Canadian transfusion medicine practitioners' challenges with current room temperature platelets (RTP) and their awareness and preference for various alternatives to room temperature platelets (Cold stored platelets / Frozen platelets / Freeze-dried platelets) for the betterment of Canadian patients. 

 Introduction: 

 Platelet (PLT) concentrates prevent and treat bleeding in thrombocytopenia or platelet dysfunction patients. Current platelet concentrates are perishable products with fixed shelf-lives of short duration—stored for only five to seven days at room temperature (RT). However, storing PLTs at room temperature increases the potential for bacteria in a contaminated unit to proliferate to clinically significant levels, requiring diligent bacterial testing or pathogen inactivation processes. In addition, the short shelf life can lead to outdated platelets, which must be discarded. This is problematic due to additional costs, the impact on availability to patients who need them, and the inability to use the donated product. Platelet shortages can potentially result in serious clinical consequences. Discards due to outdating mean that excess platelets must be produced. There are also delivery and hospital costs for laboratory inventory management and clinical activities, most of which go undocumented.   

 Considering these issues, attention has turned to investigating alternatives to room temperature storage of platelets which include : 

•  Cryopreservation of platelets at -80 °C (i.e., frozen platelets): Frozen platelets are prepared by adding 5% to 6% dimethyl sulfoxide (DMSO)to the platelets, storing them at −80°C, following collection, extending their shelf- life to 2 years for use in actively bleeding trauma patients. 

•  Refrigeration of platelets at 2-4 °C (i.e., cold platelets): Following collection, as soon as logistically possible, platelets can be stored at 1 - 6°C without agitation for up to 14 days for use in actively bleeding trauma patients. 

•  Freeze–dried platelets (i.e., lyophilized platelets): Freeze-dried platelets are prepared with freeze-drying equipment and mainly include the following steps: pretreatment with protective solutions such as trehalose, pre-freezing, drying and rehydration with rehydration solution such as 75% plasma solution.