Pressure-aided transfusion of platelets: does it affect the platelets?

Area of Science:

• Hematology
• Transfusion Medicine
• Critical Care

Background:

• Platelets (PLTs) are crucial for hemostasis but are not typically transfused using pressure infusers due to concerns about damaging PLTs.
• Massively bleeding patients often require rapid transfusion of blood products, including platelets.

Purpose of the Study:

• To investigate the effect of pressure-aided in vitro transfusion on platelet number, activation state, and function.
• To determine if pressure infusers can be safely used for platelet transfusion.

Main Methods:

• Platelet concentrates stored for 1 or 8 days were transfused in vitro using a pressure inducer (300 mmHg).
• Platelet concentration, activation markers (CD62P, CD63, PAC-1), and function (via thrombelastography) were measured before and after transfusion.
• Flow cytometry assessed activation markers on resting and stimulated platelets.

Main Results:

• Platelet concentrations remained unchanged, indicating no significant destruction during pressure-aided transfusion.
• Minor (<7%) and inconsistent changes were observed in platelet activation markers and in vitro function.
• Pressure-aided transfusion reduced in vitro platelet transfusion time by approximately 50%.

Conclusions:

• Pressure infusers do not appear to negatively impact platelet number or function during in vitro transfusion.
• The findings suggest that pressure infusers could be considered for platelet transfusion in massively bleeding patients to expedite delivery.
• In vivo studies are necessary to confirm the safety and clinical utility of pressure-aided platelet transfusion.