Cold-stored platelets being trialled in Aust hospitals

A cold platelets trial is being implemented in two Australian hospitals to test if platelets stored at 4°C are better at reducing blood loss during complex cardiac surgery than room temperature platelets.

Described as the blood’s tiny bandaids to stop major bleeding, platelets in Australia have been stored at room temperature with gentle agitation, having a shelf life of seven days, based on research from the 1970s. The Chilled Platelet Study (CHIPS) aims to examine if the product expiry can triple with the lower storage temperature.

The randomised control trial involves 1000 complex cardiac surgery patients across Australia and the US, and is open to patients from Fiona Stanley Hospital and Sir Charles Gairdner Hospital in Western Australia. Platelets will be collected at Lifeblood’s Perth Donor Centre.

CHIPS Australia Clinical Lead Researcher and Lifeblood Transfusion Medicine Specialist Dr Anastazia Keegan said recent research also shows cold-stored platelets may do a better job of controlling bleeding and offer advantages in some situations, such as in complex cardiac surgery.

“Most platelet transfusions are given to cancer patients who have low platelet counts. When platelets were first introduced in the 1960s, they were stored in the cold, but research found room temperature platelets survived longer in the body post-transfusion, so cold storage of platelets was abandoned,” Keegan said.

“This recent research by Lifeblood and others internationally suggests that cold-stored platelets may be more effective at helping blood clot. This is because cold storage causes many changes in the platelets that makes them become more activated, and ready to clot.”

The study is being led by the University of Pittsburgh and in Australia by both Australian Red Cross Lifeblood and the University of Western Australia. The clinical trial is funded by the US Department of Defense under a grant of US$26 million.

Patients in the study will be randomly assigned to receive platelets stored at 4°C or at room temperature. As the study progresses, the storage duration of cold-stored platelets may gradually be increased from seven days to a maximum of 21 days.

Lifeblood Principal Research Fellow Dr Lacey Johnson spoke specifically to the benefits of a longer expiry for platelets, saying that the change could reduce the volume of discarded platelets and stabilise supply.

“Platelets are a precious resource donated by only 2% of the population, but currently many expire before they can be used,” Johnson said.

Visit clinicaltrials.gov for more information on the trial.

Image courtesy of Australian Red Cross Lifeblood.