Cold-Stored Platelets and the Impact on Blood

Transcript:Cold-Stored Platelets and the Impact on Blood:
Cold-Stored Platelets and the Impact on Blood Center Operations James R. Stubbs, M.D. Chair, Transfusion Medicine Mayo Clinic Rochester, Minnesota Disclosures None Presentation Outline Mayo Clinic Donor Services: Who we are Mayo Clinic interest in Cold-Stored Platelets (CS-PLTs) Implementation and experience with 3-day CS-PLTs at Mayo Clinic Mayo Clinic FDA Variance for Cold Stored Platelets Covid-19 and use Room Temperature Platelets converted to CS-PLTs at Mayo Clinic Summary Mayo Clinic Donor Center Who We Are Mayo Clinic Donor Center Transfusion Medicine – Rochester Locations First two floors of Hilton Building Downtown – Center of Operations Transfusion Laboratories – Adjacent to operating rooms at Methodist and Saint Marys Hospital Therapeutic Apheresis Treatment Unit – Charlton Building of Methodist Hospital Complex Downtown Intraoperative Autotransfusion Services – Both Hospitals Blood collection facilities – Two fixed sites Hilton Building – Larger Collection Facility Saint Marys Hospital – Smaller Collection Facility Mobile blood collections – Businesses and schools (on hiatus during COVID-19) Collect only within Olmsted County – Residents, employees, visitors Hilton Building – Downtown Campus Mayo Clinic Blood Donor Center Saint Marys Hospital Helipad Blood Donor Center Mayo Clinic Donor Center What About Cold Platelets? N Engl J Med 1969; 280:1094-1098 This Paper Delivered A “Deadly Blow” to Cold-Stored Platelets Let’s Go Back In Time Slide Information – Courtesy of Dr. Andrew P. Cap Transfusion 1973; 13:61-68 “While survival in vivo, as determined with 51Cr, of platelets stored at room temperature is extremely variable, survival of platelets stored at 4°C is invariably shortened to two to three days.” “In the treatment of bleeding in thrombocytopenic patients, however, platelets kept at 4°C for 24 to 72 hours are superior to those kept at 22C with respect to their capacity to shorten the bleeding time and effect hemostasis.” On The Other Hand - Another Perspective Platelets Historically - Major indication for platelet transfusions Hypoproliferative anemia – Due to cancer and cancer treatment for example Focus – Regulatory and accrediting agencies in vivo platelet recovery and survival Platelet function – Adhesion and aggregation Not received equal consideration Determination – Optimal storage considerations RT-PLTS – “Won out” as the platelet component of choice Shouldn’t we reconsider the goals of platelet transfusions in patient care depending on the settings in which they are used? Platelet glucose metabolism, aggregation response, and clot strength were better preserved at 4⁰C compared with room temperature storage at 5 days. These data suggest that