A study recently published in Vox Sanguinis found that continuously agitating cold-stored platelets is not only unnecessary but might also introduce more logistic complexity than periodically agitating platelets or not agitating them at all.
Platelet agitation is the process of gently shaking platelet samples to help keep them functional and healthy for transfusions. Usually, platelets for transfusion are stored at room temperature and require continuous agitation. In recent years, cold-stored platelets have emerged as a potential alternative, as they carry a lower risk of bacterial growth and have a longer shelf life. However, the question of whether cold-stored platelets need to be agitated is currently debated.
Sign up here to get the latest news, perspectives, and information about FNAITFetal and neonatal alloimmune thrombocytopenia A rare condition in which a mother’s immune system attacks fetal platelets, leading to dangerously low platelet levels before and/or after birth. sent directly to your inbox. Registration is free and only takes a minute.
Platelet transfusionPlatelet transfusion A treatment for newborns with very low platelet counts that ideally uses HPA-compatible or washed maternal platelets. is a standard treatment strategy in fetal and neonatal alloimmune thrombocytopenia (FNAIT), a disease that occurs when the mother’s immune system mistakenly attacks fetal or neonatal platelets. Optimizing storage conditions is essential for streamlining management for this disease and others.
The researchers collected several platelet samples from volunteer donors. They then divided each sample into three groups: no agitation, periodic agitation and continuous agitation. They stored the platelets in a refrigerator for three weeks.
Over the study period, none of the periodically agitated or non-agitated platelets developed visible aggregates. Platelet aggregates are clumps of platelets that can sometimes form during storage and need to be discarded before transfusion. In contrast, 88% of continuously agitated platelets had aggregates by two weeks, increasing to 100% at three weeks.
Read more about FNAIT treatment and care
Storage condition was not associated with changes in the volume of blood product or platelet size distribution. The platelet concentration at Day 21 was lower than baseline for all three groups, with the continuously agitated platelets having the highest concentration.
The three groups exhibited similar decreases in glucose concentration and pH throughout the storage period. Mitochondrial function did not differ between groups either, suggesting no impact of storage condition on metabolic capacity.
“Non-agitated storage is best practice for [cold-stored platelets],” the authors concluded. “This is particularly important given the added logistical burden associated with continuous agitation, including the need for specialized equipment and space availability.”
These findings are especially relevant for facilities with limited infrastructure that do not have the means to install such equipment.
