The use of cryopreserved platelets in the treatment of polytraumatic patients and patients with massive bleeding
Abstract
BACKGROUND: The short shelf-life of fresh platelets limits their efficient inventory management and availability during a massive transfusion protocol. Risk of insufficient availability can be mitigated by building an inventory of cryopreserved platelets (CPs).
METHODS: A comparative study of fresh apheresis platelets (FAPs) and CPs was performed. Type-O CPs were processed with DMSO frozen at -80°C and reconstituted in thawed AB plasma.
All patients enrolled in the study had the following parameters evaluated on admission: vital signs (body temperature, heart rate, mean arterial pressure), blood count, prothrombin time, activated partial thromboplastin time, fibrinogen level, and, in trauma patients, international severity score. Several outcomes were evaluated: 30-day survival, adverse events, quantity of administered blood products, fibrinogen concentrate and thromboxane (TXA), and laboratory parameters after transfusion (blood count, prothrombin time, activated partial thromboplastin time, fibrinogen level).
RESULTS: Twenty-five (25) patients in the study group received transfusions totaling 81 units of CPs. Twenty-one (21) patients in the control group received a total of 67 units of FAPs.
There were no significant differences in patient characteristics (p > 0.05) between groups. Both groups were comparable in clinical outcomes (30-day survival, administered blood products, fibrinogen concentrate, TXA, and adverse events).
Among posttransfusion laboratory parameters, platelet count was higher in the group transfused with FAPs (97.0 x109/L) than in the group transfused with CPs (41.5 x109/L), p = 0.02025. Other parameters were comparable in both groups.
CONCLUSION: The study suggests that CPs are tolerable and a feasible alternative to FAPs. However, larger randomized studies are needed to draw definitive conclusions.