Background/Case Studies: Apheresis platelet inventory management is challenging given the short shelf life for such inventory. At the start of COVID-19 public health emergency, the impact of a pandemic on the availability of platelet donors and demand for platelet transfusions was unknown raising concerns for major platelet shortages that would significantly affect patients. Investigators notified the FDA of implementation of a warm to cold platelet conversion program to extend the outdate of unused apheresis platelet units to 14 days post-collection during this public health emergency. Investigators previously reported in vitro and patient safety data for such converted apheresis platelets. This study aims to describe the utilization and wastage during a warm to cold converted apheresis platelet program.
Study
Design/Methods: A warm to cold converted platelet program was implemented between April 20, 2020 and September 1, 2022 during the COVID-19 public health emergency at a single hospital-based blood bank collecting pathogen reduced apheresis platelets. Warm storage (20-24 degree C) platelets were converted to cold storage (1-6 degree C) platelets either before expiration at the end of day 5 post-collection or when warm storage platelets were returned to the blood bank in a 1-6 degree C validated blood transport container. Converted platelets were given an updated expiration date of 14 days post-collection and issued to patients with acute bleeding in the emergency department, intensive care unit, and operating room or as part of a massive transfusion protocol. Each converted platelet’s collection date, final status, transfusion or discard date, and discard reason were obtained from the hospital’s laboratory information system. Converted platelet data was grouped monthly based on transfusion or discard date for descriptive statistical analysis.
Results/Findings: Out of 2144 converted platelets which would have been otherwise discarded, 1803 (84%) were transfused to patients (Figure A). The median age of transfused converted platelets was 7 days post-collection (range 1-14 days). The remaining 341 converted platelets were discarded post-conversion most often due to clotting/excessive clumping (304; 89%). The median age of discarded converted platelets was 9 days post-collection (range 5-15 days). Conclusions: A warm to cold converted platelet program led to the transfusion of >1800 additional apheresis platelet units that would have otherwise been discarded over a 2.25 year period during the COVID-19 public health emergency. Only 16% of such converted platelets were discarded. Such a conversion program increased platelet inventory availability for patient use during a period of frequent national blood shortages.
Importance of research: Platelet inventory management is challenging particularly during a global pandemic. During the COVID-19 public health emergency, investigators conducted a warm to cold storage conversion program for pathogen reduced apheresis platelets at a single hospital-based blood donor center. This program led to the transfusion of >1800 platelet units over 2.25 years that would have otherwise been discarded. Such an approach may be a practical option to help address platelet inventory shortages.
