Transition from room temperature to cold‐stored platelets for the preservation of blood inventories during the COVID‐19 pandemic

Warner, Matthew A.; Kurian, Emil B.; Hammel, Scott A.; van Buskirk, Camille M.; Kor, Daryl J.; Stubbs, James R.

BACKGROUND: The COVID‐19 pandemic has placed great strain on blood resources. In an effort to extend platelet (PLT) shelf life and minimize waste, our institution transitioned room temperature to cold‐stored PLTs for administration to bleeding patients. STUDY DESIGN AND METHODS: We describe the administrative and technical processes involved in transitioning room temperature PLTs to cold storage in April 2020. Additionally, we describe the clinical utilization of cold‐stored PLTs in the first month of this practice change, with a focus on changes in PLT counts after transfusion, hemostasis, and safety outcomes. RESULTS: A total of 61 cold‐stored PLT units were transfused to 40 bleeding patients, with a median (interquartile range [IQR]) of 1 (1‐2) units per patient. The median age was 68 (59‐73) years; 58% male. Median pretransfusion and posttransfusion PLTs counts were 88 (67‐109) and 115 (93‐145). A total of 95% of transfusions were administered in the operating room: 57% cardiac surgery, 20% vascular surgery, 8% general surgery, and 5% solid organ transplantation. Hemostasis was deemed to be adequate in all cases after transfusion. There were no transfusion reactions. One patient (3%) experienced a fever and infection within 5 days of transfusion, which was unrelated to transfusion. Median (IQR) hospital length of stay was 8.5 (6‐17) days. Two patients (5%) died in the hospital of complications not related to transfusion. CONCLUSION: Cold‐stored PLT utilization was associated with adequate hemostasis and no overt signal for patient harm. Conversion from room temperature to cold‐stored PLTs may be one method of reducing waste in times of scarce blood inventories.