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

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.