Splitting apheresis platelets as a contingency measure for inventory shortages

Area of Science:

• Transfusion Medicine
• Hematology
• Blood Banking

Background:

• Splitting apheresis platelet (PLT) units can increase inventory during shortages.
• The impact of prolonged storage in gas-impermeable aliquot bags on PLT quality and transfusion outcomes is not well understood.

Purpose of the Study:

• To evaluate the in vitro quality of apheresis platelets stored in aliquot bags for up to 24 hours.
• To assess transfusion response in adult patients receiving split platelet units.

Main Methods:

• In vitro PLT quality and thromboelastography (TEG) were assessed in PLTs stored for 8 or 24 hours.
• Retrospective analysis of PLT increment and corrected count increment (CCI) in adults transfused with split PLT units.

Main Results:

• No significant differences in PLT counts, WBC counts, or mean platelet volume were observed during storage.
• TEG R time increased significantly at 24 hours compared to baseline.
• Non-pathogen-reduced (PR) split PLTs showed higher median PLT count increments and CCIs compared to PR splits.

Conclusions:

• Storing PLTs in aliquot bags for up to 24 hours does not adversely affect in vitro quality.
• Splitting apheresis PLTs is a viable strategy to manage inventory during shortages.
• Prioritizing non-PR PLTs for splitting may lead to improved patient transfusion responses.