Balanant, MA

Bower, L

Cardigan, R

Green, L

Horner, E

Huish, S

Jolley, J

Kempster, C

Lewandowski, L

Smethurst, P

Wiltshire, M

British Journal of Haematology

English

Queen Mary Research Online

BSH2020TransfusionBSH2020-710Re-evaluating the shelf-life of whole blood for use in trauma: impact of storage on platelet function.Sian Huish1, Laura  Green 2, 3, Carly Kempster4, Peter Smethurst1, Michael Wiltshire1, Lucy Bower1, Jennifer Jolley1,Marie Anne Balanant1, Lubosz Lewandowski1, Emily Horner5, Rebecca  Cardigan* 1, 61NHS Blood and Transplant, Cambridge, 2NHS Blood and Transplant, 3Barts Health Trust, London, 4University ofReading, Reading, 5Imperial College, London, 6University of Cambridge, Cambridge, United KingdomPlease indicate your preferred method of presentation: OralDo you wish to be considered for a BSH Abstract Scholarship?: NoHas this abstract been presented at a UK national haematology meeting before?: NoHas this abstract been presented at an overseas meeting?: NoDoes your abstract relate to any aspects of paediatrics?: NoPlease select your position from the following list:: ScientistAbstract Content: Background: There is an immense interest in using Whole Blood (WB) transfusion for earlyresuscitation of trauma patients with major bleeding in the pre-hospital setting. The shelf-life of WB component (21-35days depending on jurisdiction) was established decades ago, primarily based on the viability of red cells. This studyaimed to determine the platelet function of leucocyte-depleted WB (LD-WB) over storage in order to re-establish the shelflife.Methods: LD-WB was prepared using a platelet-sparing LD filter (Terumo WB-SP Imuflex). LD-WB was held at 2 – 6 ºCalongside comparator arms consisting of: A) UK standard pooled buffy coat platelets stored at 20 - 24 °C (RT-PLTS) B)pooled platelets held at 2 - 6 °C (COLD PLTS) and C) platelet rich plasma (PRP) produced using the Terumo Imuflex WB-SP kit, for 21 days. A series of in vitro assays were assessed.Results: There were fundamental changes in the platelet function of LD-WB over storage at 2 – 6 °C for 21 days. Plateletcount was retained to a mean of 57 ± 14 % of starting number at day 21 in 80 % of LD-WB components compared with97 ± 2 % at end of shelf  life (day 7) in RT-PLTS. Over time the platelets in LD-WB become more activated, as seen inincreased CD62P expression (Day 1 - 7 ± 3.7 % vs. Day 21 - 59 ± 17.1 %) and annexin V binding (Day 1 – 2 ± 0.2 % vs.Day 21 – 21 ± 15.1 %). For comparison, 18.6 ± 6 % of platelets in RT-PLTS demonstrated CD62P expression at day 7whilst  Annexin V binding in RT-PLTS at  day 7 was 2.6 ± 0.5 %. LD-WB demonstrated decreased response to agonistsover time (CD62P expression with ADP: (Day 1 - 73 ± 9 %, Day 21: 13 ± 8 %), TRAP-6: (Day 1 - 80 ± 6 %, Day 21 – 13± 8 %), CRP-XL: (Day 1 - 64 ± 15 %, Day 21 – 11 ± 12 %).  From day 12 onwards, LD-WB showed very little ability toaggregate in response to ADP and TRAP-6. Platelet-derived microparticles increased steadily throughout storage, whichcorresponded with increased potential to promote thrombin generation (Day 1 – 72 ± 5.7 s to clot vs. Day 21 – 38 ± 3.5 sto clot) in LD-WB. Metabolism was higher in RT-PLTS than cold-stored components.Conclusion:  During  storage  of  LD-WB,  there  is  a  substantial  loss  of  platelet  count,  coupled  with  progressive  loss  ofaggregatory response, and increased activation. These data, along with previously published work to understand red cellfunction  and plasma quality  in  LD-WB in  vitro  and international  experience,  were  used to  recommend a  shelf  life  of  14days for LD-WB in the UK. This work is part of ongoing collaborative efforts to establish the clinical need and feasibility ofWB in the treatment of major haemorrhage, particularly in the pre-hospital environment.  Disclosure of Interest: None Declared

Re-evaluating the shelf-life of whole blood for use in trauma: impact of storage on platelet function

https://qmro.qmul.ac.uk/xmlui/bitstream/handle/123456789/66604/Greeen_Re-evaluating%20the%20shelf-life%20of%20whole%20blood-Abstract_Accepted-ms_2020.pdf?sequence=2&isAllowed=y

Re-evaluating the shelf-life of whole blood for use in trauma: impact of storage on platelet function

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