The Use of Cold Stored Platelets for Surgical Patients

by Dr. Frances Compton

We have seen great success since the implementation of cold stored platelets (CSPs) on January 17, 2022. This new blood component has been a valuable product for bleeding patients; allowed for a longer shelf-life of a limited resource and provided inventory relief during the local winter storms.

While many hospitals have benefitted by being able to keep a CSP on their refrigerator shelf without needing to utilize a platelet rotator, other larger trauma hospitals have been able to provide this pre-activated product, which is primed for hemostasis, to their bleeding patients. Our CSP FDA variance is approved for use in “actively bleeding patients,” allowing many of these products to be ultimately transfused in a massive transfusion protocol (MTP) shipment or out of a trauma ED refrigerator. This is certainly a useful and productive way to take advantage of the benefits of this product, as preliminary studies suggest that CSP products are superior at bleeding control.(1)


A local, non-trauma hospital has also been able to utilize the advantages of this product in the operating room (OR). This surgical hospital has transfused 46 CSPs to cardiovascular surgical patients. The use of CSPs in surgical patients is of great interest in the medical community. In fact, there is an ongoing clinical trial called CHIPS (CHIlled Platelet Study), funded in part by the US Department of Defense, which plans to evaluate the non-inferiority/superiority of CSP transfusion at multiple storage durations (up to 21 days) in complex cardiac surgery cases.(2) Two of the key outcomes being investigated are perioperative bleeding score and chest tube output. The study, still in the recruitment phase, is a phase 3 randomized partially blind study which will include 1,000 study participants.

Is your hospital interested in transfusing CSPs in the OR? The clinical and logistical benefits of CSPs are likely equally beneficial for both trauma and OR situations (as well as other bleeding scenarios). Furthermore, the local surgical hospital that has successfully implemented the use of these products has not wasted a single CSP product due to improper OR cooler packing to date. CSPs are, in fact, easier and simpler to handle for OR staff as they can be packed with RBCs and thawed plasma in a chilled cooler. To ensure your hospital has access to this life-saving product, contact hospitalrelations@carterbloodcare.org.

References:

  1. Reddoch-Cardenas KM, Bynum JA, Meledeo MA et al. Cold-stored platelets: A product with function optimized for hemorrhage control. Transfusion and Apheresis Science. 2019; 58: 16-22.

  2. ClinicalTrials.gov; CHIlled Platelet Study “CHIPS” (CHIPS) https://www.clinicaltrials.gov/ct2/show/NCT04834414