Platelet transfusions are lifesaving for cancer patients, those receiving organ or bone marrow transplants, victims of traumatic injuries, and patients undergoing heart surgery. Every time that you roll up your sleeve and donate platelets, you are giving a patient in need a better chance at recovery. At Bloodworks Research Institute, we are dedicated to maximizing the amount of good that your donation makes possible, searching for new ways to improve the safety and efficacy of blood.
In particular, my lab is studying if the way that we store platelets after donation impacts their effectiveness. Under current standards, donated platelets are stored at room temperature and can be stored for up to 5 days. However, we have shown that storing platelets in the refrigerator instead of at room temperature can lead to better platelet function, and that in cases of active bleeding like surgery and trauma, these cold-stored platelets may be a better clinical choice.
This fall, my lab will be launching a clinical study to investigate the effectiveness of cold-stored platelets in cardiac surgery patients, funded through a new 4-year grant from the US Army Medical Research Program.
400,000 heart surgeries are performed in the US every year. A majority of these patients require the use of a cardiopulmonary bypass pump that maintains blood circulation during surgery. However, the plastic tubing on the bypass pump causes platelets to lose function, putting cardiac surgery patients at high risk for bleeding. To counteract this, heart surgery patients frequently receive transfusions of room-temperature platelets to stop or reduce bleeding. My team will be testing if refrigerated platelets are better than room-temperature platelets at stopping bleeding in cardiac surgery patients at Swedish Medical Center who come off bypass. We will test for platelet function during and after surgery, measure how much blood is lost, and other parameters.
If we find that refrigerated platelets are better at reducing or stopping blood loss, all bleeding patients, not just cardiac surgery patients, could benefit. We could see reduced blood loss after trauma or surgeries, shorter intensive care unit stays, shorter hospitalizations, and fewer deaths after surgeries.
Today, blood banks can get permission from the Food and Drug administration to store donated platelets in the refrigerator, but only for three days. This is impractical for trauma patients in remote areas like rural hospitals or on the battlefield. If our study shows an advantage for cold-stored platelets, this could have an immediate impact and improve transfusion practice for all actively bleeding patients, including military servicemen and veterans alike.
Apart from the benefit for actively bleeding patients, this study could also have a marked impact on blood banking practices. By storing platelets in the fridge, we reduce the risk of bacterial growth and therefore could safely store platelets for longer periods. Storage time of cold-stored platelets could be extended to 15 or even 20 days, greatly alleviating shortages, reducing waste from outdating and thereby improving the blood supply both locally and at remote hospitals and military stations.
Dr. Moritz Stolla is an Assistant Member of the Bloodworks Research Institute and Associate Medical Director of the Blood Transfusion Service at Swedish Medical Center. Dr. Stolla and his team at Bloodworks study platelets, the blood cells that help control bleeding.