Comparative analysis of cold-stored platelets using Golden Hour transport boxes: Function and quality

Area of Science:

• Emergency Medicine
• Transfusion Medicine
• Critical Care

Background:

• Prehospital critical care services face challenges storing platelet concentrates (PCs) at 22°C with agitation.
• Cold-stored platelets (CSP) at 4°C offer potential for improved hemostasis and longer storage.
• Investigating CSP storage in Golden Hour (GH) boxes for prehospital use is crucial.

Purpose of the Study:

• To assess the viability of storing CSP in GH boxes for up to 96 hours.
• To evaluate the impact of GH box storage on platelet function and viability.
• To determine the potential for enhanced prehospital damage control resuscitation.

Main Methods:

• PCs were stored as CSP (4°C, no agitation) or GH-CSP (GH box days 2-6, then refrigeration).
• In vitro assessments included aggregometry, thrombin generation, thromboelastography, and platelet activation markers (P-selectin, annexin V).
• Temperature stability of GH boxes with CSP and red cell concentrates was monitored.

Main Results:

• GH boxes maintained 2-6°C for up to 84 hours with CSP and red cells.
• Platelet function assays showed no significant differences between CSP and GH-CSP.
• GH-CSP exhibited increased annexin V binding on days 8 and 15 compared to CSP.

Conclusions:

• CSP stored in GH boxes demonstrated comparable platelet function to conventional CSP.
• GH box storage of CSP is a potentially viable method for prehospital applications.
• This approach could expand the use of CSP in prehospital damage control resuscitation.