Temperature cycling during platelet cold storage improves in vivo recovery and survival in healthy volunteers

BACKGROUNDRoom temperature (RT) storage of platelets (PLTs) can support bacterial proliferation in contaminated units, which can lead to transfusion-transmitted septic reactions. Cold temperature storage of PLTs could reduce bacterial proliferation but cold exposure produces activation-like changes in PLTs and leads to their rapid clearance from circulation. Cold-induced changes are reversible by warming and periodic rewarming during cold storage (temperature cycling [TC]) has been proposed to alleviate cold-induced reduction in PLT circulation. STUDY DESIGN AND METHODSA clinical trial in healthy human volunteers was designed to compare in vivo recovery, survival, and area under the curve (AUC) of radiolabeled autologous apheresis PLTs stored for 7 days at RT or under TC or cold conditions. Paired comparisons of RT versus TC and TC versus cold PLTs were conducted. RESULTSRoom temperature PLTs had in vivo recovery of 55.713.9%, survival of 161.3 +/- 28.8 hours, and AUC of 5031.2 +/- 1643.3. TC PLTs had recovery of 42.6 +/- 16.4%, survival of 48.1 +/- 14.4% hours, and AUC of 1331.3 +/- 910.2 (n=12, p<0.05). In a separate paired comparison, cold PLTs had recovery of 23.1 +/- 8.8%, survival of 33.7 +/- 14.7 hours, and AUC of 540.2 +/- 229.6 while TC PLTs had recovery of 36.5 +/- 12.9%, survival of 49.0 +/- 17.3 hours, and AUC of 1164.3 +/- 622.2 (n=4, AUC had p<0.05). CONCLUSIONTC storage for 7 days produced PLTs with better in vivo circulation kinetics than cold storage but is not equivalent to RT storage.