title: Refrigerated platelets for the treatment of acute bleeding: a review of the literature and reexamination of current standards.
abstract: This review is a synopsis of the decisions that shaped global policy on platelet (PLT) storage temperature and a focused appraisal of the literature on which those discussions were based. We hypothesize that choices were centered on optimization of preventive PLT transfusion strategies, possibly to the detriment of the therapeutic needs of acutely bleeding patients. Refrigerated PLTs are a better hemostatic product, and they are safer in that they are less prone to bacterial contamination. They were abandoned during the 1970s because of the belief that clinically effective PLTs should both be hemostatically functional and survive in circulation for several days as indicated for prophylactic transfusion; however, clinical practice may be changing. Data from two randomized controlled trials bring into question the concept that stable autologous stem cell transplant patients with hypoproliferative thrombocytopenia should continue to receive prophylactic transfusions. At the same time, new findings regarding the efficacy of cold PLTs and their potential role in treating acute bleeding have revived the debate regarding optimal PLT storage temperature. In summary, a "one-size-fits-all" strategy for PLT storage may not be adequate, and a reexamination of whether cold-stored PLTs should be offered as a widely available therapeutic product may be indicated.
authors.affiliation: *Blood Research Program, US Army Institute of Surgical Research, Fort Sam Houston, Texas; †Department of Critical Care, Department of Pediatrics, Washington University in St Louis, Missouri; ‡Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, Texas; §Norwegian Naval Special Operation Commando and ∥Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway; and ¶Division of Transfusion Medicine, Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Heather F
authors.initials: HF
authors.lastname: Pidcoke
authors.forename: Philip C
authors.initials: PC
authors.lastname: Spinella
authors.forename: Anand K
authors.initials: AK
authors.lastname: Ramasubramanian
authors.forename: Geir
authors.initials: G
authors.lastname: Strandenes
authors.forename: Tor
authors.initials: T
authors.lastname: Hervig
authors.forename: Paul M
authors.initials: PM
authors.lastname: Ness
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Cap
mesh_terms: D001424:Bacterial Infections / Q000517:prevention & control; D001792:Blood Platelets; D001793:Blood Preservation / Q000379:methods; D003080:Cold Temperature; D006470:Hemorrhage / Q000628:therapy*; D006487:Hemostasis; D006801:Humans; D017713:Platelet Transfusion / Q000009:adverse effects / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012034:Refrigeration; D013921:Thrombocytopenia / Q000628:therapy