The use of cryopreserved platelets in a trauma-induced hemorrhage model
2020
Background: Cryopreserved platelet products can be stored for years and are
mainly used in military settings. Following thawing, cryopreserved platelets
are activated, resulting in faster clot formation but reduced aggregation in
vitro, rendering their efficacy in bleeding unknown. Also, concerns remain on
the safety of these products. The aim was to investigate the efficacy and safety
of cryopreserved platelets in a rat model of traumatic hemorrhage.
Study Design and Methods: After 1 hour of shock, rats (n = 13/group) were
randomized to receive a balanced transfusion pack (1:1:1 red blood cell:plasma:
platelet) made from syngeneic rat blood, containing either liquid stored platelets
or cryopreserved platelets. Primary outcome was the transfusion volume
required to obtain a mean arterial pressure (MAP) of 60 mmHg. Secondary outcomes were coagulation as assessed by thromboelastometry (ROTEM®) and
organ failure as assessed by biochemistry and histopathology.
Results: The transfusion volume to obtain a MAP of 60 mmHg was lower in
animals receiving cryopreserved platelets (5.4 [4.1-7.1] mL/kg) compared to
those receiving liquid stored platelets (7.5 [6.4-8.5] mL/kg, p < 0.05). ROTEM®
clotting times were shorter (45 [41-48] vs. 49 [45-53]sec, p < 0.05), while maximum clot firmness was slightly lower (68 [67-68] vs. 69 [69-71]mm, p < 0.01).
Organ failure was similar in both groups.
Conclusions: Use of cryopreserved platelets required less transfusion volume
to reach a targeted MAP compared to liquid stored platelets, while organ injury
was similar. These results provide a rationale for clinical trials with
cryopreserved platelets in (traumatic) bleeding.
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