Cold Platelet Transfusion: the Effects of a Fluid Warmer on Platelet Function.

Background: Recently the US Food and Drug Administration has granted variances to select blood centers to supply cold-stored platelet components (CSP). In hemorrhage resuscitation warming of blood components with approved fluid warming devices is common.Study Design and Methods: Pathogen-reduced apheresis platelet units were collected and stored in one of two ways: (1) CSP-I, (2) CSP-D. CSP-I were collected and immediately stored at 1-6 degrees C until used. CSP-D were collected and stored at 20-24 degrees C for 5 days and transferred to storage at 1-6 degrees C until use. Aggregometry using arachidonic acid (AA), adenosine diphosphate (ADP) and collagen as agonists was performed on the unit samples before and after the units were infused through a Ranger blood-warming device.Results: CSP-I, 23 units, had very high aggregation responses to all agonists (all >= 47.6 +/- 20.7). There was a statistically significant reduction in ADP-induced aggregometry results from 55.1 +/- 23.2 before compared to 33.5 +/- 14.6 following infusion of the PLT through the blood warmer (p < .001). There were no differences in AA and collagen aggregometry results before and after the infusion of the platelets through the blood warmer. CSP-D had 5 of the 15 units with visible clotting in the bag. The 10 CSP-Ds studied had lower aggregation than all agonists before and after infusion through the blood-warming device (all <= 49.9 +/- 35.9).Conclusion: We detected a statistically significant reduction in ADP-induced aggregometry in CSP-I run through a Ranger blood-warming device with no change with AA or collagen agonist aggregometry.