title: Platelet utilization: a Canadian Blood Services research and development symposium.
abstract: Considerable progress has been made in recent years in understanding platelet biology and in strengthening the clinical evidence base around platelet transfusion thresholds and appropriate platelet dosing. Platelet alloimmunization rates have also declined. Nevertheless, controversies and uncertainties remain that are relevant to how these products can best be used for the benefit of platelet transfusion recipients. Platelets are unique among the blood products directly derived from whole blood or apheresis donations in requiring storage, with shaking, at ambient temperature. Storage is accordingly constrained between the need to limit the growth of any microbes in the product and the need to minimize losses in platelet function associated with storage. Proteomic and genomic approaches are being applied to the platelet storage lesion. Platelet inventory management is made challenging by these constraints. Although bacterial screening has enhanced the safety of platelet transfusions, pathogen reduction technology may offer further benefits. Continuing clinical investigations are warranted to understand the value of transfusing platelets prophylactically or only in response to bleeding in different patient groups and how best to manage the most grievously injured trauma patients. Patients refractory to platelet transfusions also require expert clinical management. The engineering of platelet substitute products is an active area of research, but considerable hurdles remain before any clinical uses may be contemplated. Roles for platelets in biological areas distinct from hemostasis are also emerging. Platelet utilization is variably affected by all of the above factors, by demographic changes, by new medications, and by new patient care approaches.
authors.affiliation: Utilization, Medical Services and Innovation, Canadian Blood Services, Hamilton and Ottawa, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Webert
authors.affiliation: Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Pathology and Laboratory Medicine, University of Toronto, Toronto, Canada.
authors.forename: Asim Q
authors.initials: AQ
authors.lastname: Alam
authors.affiliation: Centre for Innovation (formerly Research and Development), Medical Services and Innovation, Canadian Blood Services, Hamilton and Ottawa, Canada.
authors.forename: Sophie B
authors.initials: SB
authors.lastname: Chargé
authors.affiliation: Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada; Centre for Innovation (formerly Research and Development), Medical Services and Innovation, Canadian Blood Services, Hamilton and Ottawa, Canada. Electronic address: sheffiel@mcmaster.ca.
authors.forename: William P
authors.initials: WP
authors.lastname: Sheffield
mesh_terms: D001424:Bacterial Infections / Q000517:prevention & control; D001771:Blood Banks; D001792:Blood Platelets / Q000166:cytology / Q000382:microbiology* / Q000821:virology*; D001793:Blood Preservation / Q000379:methods; D001803:Blood Transfusion / Q000379:methods; D002170:Canada; D002986:Clinical Trials as Topic; D006801:Humans; D007391:International Cooperation; D008081:Liposomes / Q000737:chemistry; D017713:Platelet Transfusion / Q000379:methods*; D018805:Sepsis / Q000517:prevention & control
chemical_list: D008081:Liposomes