Platelet functionality in cold-stored whole blood

Abstract

Whole blood is currently being reintroduced as a blood product to be used in massive bleeding situations because it affords plasma, red cells and platelets in a balanced ratio and in a logistical advantageous way. Questions concerning the haemostatic potential of the platelets have arisen, especially in cold‐stored whole blood, as this is the major whole blood product in use. When reviewing current knowledge on this, there is an abundance of publications demonstrating that in vitro, platelets in cold‐stored whole blood have a haemostatic capacity up to 14 days, and even after 21 and 35 days of storage depending on type of additive solution. There is a paucity of data on clinical trials of cold‐stored platelets, whereas there is an abundance of previous clinical experience with whole blood, both cold‐stored and fresh, as an efficacious and safe product for use in pre‐ and in‐hospital patients with life‐threatening bleeding.