Ever since platelets stored at room temperature were shown to survive longer in circulation than those stored at colder temperatures, platelets have been stored at room temperature (with a shelf life of 5 to 7 days). In 2023, the U.S. Food and Drug Administration (FDA), however, approved the use of cold stored platelets (CSP) (with a shelf life up to 14 days) for hemorrhaging patients when room temperature platelets are not available. To examine the safety and efficacy of CSP, researchers randomized 200 trauma patients (average age, 34 years; 85% male; 79% penetrating injury) in a phase 2 clinical trial to receive either one unit of CSP in addition to standard care or standard care alone. All patients (n=102) in the CSP arm received one unit of platelets significantly earlier than the 47% of the 98 patients in the standard care arm who received at least one unit of room temperature platelets; the median time to the first platelet transfusion was 31 minutes compared to 87 minutes, respectively (p<0.01). The number of patients who died within 24 hours was not significantly different by study arm—5.9% in the CSP arm vs 10.2% in the standard care arm (p=0.26). In addition, there was no difference in thrombotic events or other adverse events between study arms. The study results suggest that CSP may be safe, but larger clinical trials are needed to better characterize CSP in trauma patients and other bleeding patients.
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