Platelets must be stored at room temperature to preserve function, which makes them susceptible to bacterial contamination. Recently, several countries including the United States and Canada have extended platelet storage time from five days to seven days with bacterial testing. In order to evaluate the clinical impacts of this policy change, researchers in Canada retrospectively evaluated adult inpatients (median age 66 years; 45% cardiac surgery inpatients) who received a single dose of platelets (pooled or apheresis) either before (N=1360; February 2016 to July 2017) or after the storage policy changed (N=1211; September 2017 to February 2019) using data from the Transfusion Research Utilization, Surveillance and Tracking database. Mean absolute platelet count increments trended lower during the seven-day storage period compared to the five-day storage period. Based on mean platelet counts of all inpatients, however, platelets transfused during the seven-day storage period were non-inferior to platelets transfused during the five-day storage period (mean count difference -4.63 X 109/L, p=0.0001). In subgroup analyses for platelet count increments non-inferiority was achieved for oncology and non-cardiac surgery patients but not for cardiac surgery, medical ICU, and other patients. Platelet expiry decreased after the storage policy change (6.3% vs 8.1%, p<0.0001), and no significant differences were observed in clinical and safety outcomes. Further research is needed to fine-tune platelet storage to ensure adequate supplies along with maximum hemostatic effectiveness for all patients.
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