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

Area of Science:

• Transfusion Medicine
• Blood Component Processing
• Hemostasis and Thrombosis

Background:

• US FDA permits variances for cold-stored platelets (CSP).
• Fluid warming devices are commonly used for blood components during hemorrhage resuscitation.

Purpose of the Study:

• To evaluate the impact of a blood-warming device on the function of two types of cold-stored platelets (CSP-I and CSP-D).
• To assess platelet aggregometry before and after infusion through a Ranger blood-warming device.

Main Methods:

• Pathogen-reduced apheresis platelet units were stored as CSP-I (1-6°C) or CSP-D (20-24°C for 5 days, then 1-6°C).
• Aggregometry was performed using arachidonic acid (AA), adenosine diphosphate (ADP), and collagen agonists.
• Platelet samples were tested before and after passing through a Ranger blood-warming device.

Main Results:

• CSP-I units showed high aggregation responses to all agonists.
• A significant reduction in ADP-induced aggregation was observed in CSP-I after warming (55.1±23.2 to 33.5±14.6, p<.001).
• No significant changes in AA or collagen-induced aggregation were noted for CSP-I post-warming. CSP-D units had lower aggregation and some exhibited clotting.

Conclusions:

• Warming CSP-I through a Ranger device significantly reduces ADP-induced platelet aggregation.
• Platelet function, specifically ADP-induced aggregation, may be altered by warming devices.
• Further research is needed to understand the clinical implications of warming-induced changes in CSP function.