Transfusion. 2020 Oct 8. doi: 10.1111/trf.16148. Online ahead of print.
INTRODUCTION: The COVID-19 pandemic has placed great strain on blood resources. In an effort to extend platelet shelf-life and minimize waste, our institution transitioned room-temperature to cold-stored platelets for administration to bleeding patients.
STUDY DESIGN AND METHODS: We describe the administrative and technical processes involved in transitioning room-temperature platelets to cold-storage in April 2020. Additionally, we describe the clinical utilization of cold-stored platelets in the first month of this practice change, with a focus on changes in platelet counts after transfusion, hemostasis, and safety outcomes.
RESULTS: A total of 61 cold-stored platelet units were transfused to 40 bleeding patients, with a median (interquartile range) of 1 (1, 2) units per patient. The median age was 68 (59, 73) years; 58% male. Median pre-transfusion and post-transfusion platelets counts were 88 (67, 109) and 115 (93, 145). 95% of transfusions were administered in the operating room; 57% cardiac surgery, 20% vascular surgery, 8% general surgery, and 5% solid-organ transplantation. Hemostasis was deemed to be adequate in all cases after transfusion. There were no transfusion reactions. One patient (3%) experienced a fever and infection within 5 days of transfusion, which was unrelated to transfusion. Median hospital length of stay was 8.5 (6, 17) days. Two patients (5%) died in the hospital of complications not related to transfusion.
CONCLUSION: Cold-stored platelet utilization was associated with adequate hemostasis and no overt signal for patient harm. Conversion from room-temperature to cold-stored platelets may be one method of reducing waste in times of scarce blood inventories. This article is protected by copyright. All rights reserved.