Hospitals in low- and middle-income countries, as well as military and rural hospitals in high-income countries, lack reliable access to platelets because standard, liquid-stored platelets have a short shelf life at room temperature. Based on a limited number of studies with small sample sizes, cryopreserving platelets in dimethyl sulfoxide (DMSO), which extends the shelf life of platelets to two years, may provide an alternative method to store platelets—especially in “platelet deserts.” The Cryopreserved vs Liquid Platelets II (CLIP-II) noninferiority trial randomized 388 adult cardiac surgery patients (mean age, 64 years; 76% male) with a high risk of bleeding at 11 hospitals in Australia to receive either cryopreserved platelets or standard liquid-stored platelets for up to three units. Of the 202 patients who required platelet transfusion, 104 received cryopreserved and 98 received standard platelets. Although noninferiority based on the pre-specified 20% margin was not established, no significant difference was observed between cryopreserved and standard platelets in the primary outcome of post-surgical bleeding during the first 24 hours in the ICU, with patients in the cryopreserved arm losing a geometric mean of 605 mL of blood (95% CI, 532-688) compared with 535 mL (95% CI, 480-596) in the standard arm (p=0.07). However, cryopreserved platelets were associated with greater total blood loss, increased transfusions of RBCs and other blood components, and longer hospital stays. Additional research is needed on platelet products for other types of patients in “platelet deserts.”
References:
- Reade MC, Marks DC, Howe BD, Bailey MJ et al. Cryopreserved vs Liquid-Stored Platelets for the Treatment of Surgical Bleeding: The CLIP-II Randomized Noninferiority Clinical Trial. Published online December 08, 2025
- Neal MD, Spinella PC, Kornblith LZ. An Oasis in the Platelet Desert? JAMA. Published online December 08, 2025
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