(P-TS-33) Comparison of Clinical Outcomes in Patients Transfused with Cold-Stored Platelets vs Room-Temperature Platelets

Background/Case Studies: Platelet transfusions are a necessary treatment in actively bleeding patients to help blood clot formation and cease bleeding. Historically, platelets are stored at room-temperature (20 to 24 degrees Celsius) with constant agitation which promotes bacterial growth and limits the blood supply due to the short expiration of 5-7 days. An alternative to room-temperature platelets (RTP) are cold-stored platelets (CSP) which are stored at 1 to 6 degrees Celsius for up to 14 days. The cold temperature helps mitigate bacterial growth and increases platelet shelf life from 5-7 days to 14 days. This study evaluates whether CSP are as effective in treating active bleeds as RTP by comparing post-transfusion platelet change.

Study

Design/Methods: A retrospective cohort study was conducted on actively bleeding patients over the age of 18, who have been given the actively bleeding indication for platelet transfusion or have had a massive transfusion protocol (MTP) ordered. The study was conducted at multi-site healthcare system associated with an academic center from August 2023 to January 2025. Patient demographics, platelet transfusion type (CSP or RTP), pre-transfusion platelet count, 1-hour and 24-hour post-transfusion platelet count were obtained. All patient demographics were compared through a chi square analysis, except for age which was analyzed through a Kruskal-Wallis test. The post-transfusion platelet count change between CSP and RTP was compared through a Kruskal-Wallis test.

Results/Findings: The patient demographics (age, sex, ethnicity, race, diagnosis, and location) between the groups were not statistically significant (all p >0.05). The 1-hour change in platelet count for CSP transfusions had a median of 11 (x10³/μL) with a range of -278 to 30 (x10³/μL), and for RTP transfusions the median was 13 (x10³/μL) with a range of -278 to 91 (x10³/μL). The 1-hour change in platelet count showed no significant difference between CSP and RTP with a p value of 0.116. The 24-hour change in platelet count for CSP transfusions had a median of -13 (x10³/μL) with a range of -261 to 29 (10³/μL), and for RTP transfusions the median was 10 (x10³/μL) with a range of -261 to 59 (x10³/μL). The 24-hour change in platelet count was significantly different with a p-value of 0.007.

Conclusions: There was no significant difference between the patients that received CSP vs RTP in demographics and the change in platelet count at 1-hour. The change in platelet count at 24 hours was significantly different between CSP and RTP, which correlates with previous studies that show CSP are cleared more rapidly in the body than RTP. The 1-hour change in platelet count shows that both types of platelet transfusions result in similar platelet circulation at 1 hour, which is significant because the use of CSP extends the life shelf of platelet units. A limitation to this study was the limited sample size, which limits the generalizability.