Cold platelet transfusion: The effects of a fluid warmer on platelet function

Transfusion. 2024 Jan;64(1):47-52. doi: 10.1111/trf.17624. Epub 2023 Dec 19.

Abstract

Background: Recently the US Food and Drug Administration has granted variances to select blood centers to supply cold-stored platelet components (CSP). In hemorrhage resuscitation warming of blood components with approved fluid warming devices is common.

Study design and methods: Pathogen-reduced apheresis platelet units were collected and stored in one of two ways: (1) CSP-I, (2) CSP-D. CSP-I were collected and immediately stored at 1-6°C until used. CSP-D were collected and stored at 20-24°C for 5 days and transferred to storage at 1-6°C until use. Aggregometry using arachidonic acid (AA), adenosine diphosphate (ADP) and collagen as agonists was performed on the unit samples before and after the units were infused through a Ranger blood-warming device.

Results: CSP-I, 23 units, had very high aggregation responses to all agonists (all ≥47.6 ± 20.7). There was a statistically significant reduction in ADP-induced aggregometry results from 55.1 ± 23.2 before compared to 33.5 ± 14.6 following infusion of the PLT through the blood warmer (p < .001). There were no differences in AA and collagen aggregometry results before and after the infusion of the platelets through the blood warmer. CSP-D had 5 of the 15 units with visible clotting in the bag. The 10 CSP-Ds studied had lower aggregation than all agonists before and after infusion through the blood-warming device (all ≤49.9 ± 35.9).

Conclusion: We detected a statistically significant reduction in ADP-induced aggregometry in CSP-I run through a Ranger blood-warming device with no change with AA or collagen agonist aggregometry.

Keywords: aggregometry; allogeneic; apheresis; blood warmer; cold; platelet transfusion; platelet unit; platelet warming.

MeSH terms

  • Adenosine Diphosphate / pharmacology
  • Blood Platelets
  • Blood Preservation / methods
  • Cold Temperature
  • Collagen / pharmacology
  • Humans
  • Platelet Aggregation*
  • Platelet Transfusion* / methods

Substances

  • Collagen
  • Adenosine Diphosphate