Blood Without Borders: The Emerging World of Cold-Store Platelets

By Ramin A. Khalili, USAMRMC Combat Casualty Care Research ProgramAugust 20, 2015

Blood Without Borders: The Emerging World of Cold-Store Platelets
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Blood Without Borders: The Emerging World of Cold-Store Platelets
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After moderating a lengthy session on blood products at the 2015 Military Health System Research Symposium in Fort Lauderdale, Florida, Aug. 18, Dr. Heather Pidcoke summed up two hours of dense technological conversation into just five words.

"Ultimately, it's about saving lives," said Pidcoke.

Simply put for such a complicated issue, and yet words that sum up decades of emerging research at the same time.

With the June 2015 ruling by the U.S. Food and Drug Administration clearing the use of cold-stored apheresis platelets for the resuscitation of bleeding patients, the effort to stretch the limits of cold platelet storage has gained renewed traction.

Platelets are the component in blood that team with red blood cells and plasma to form clots that can help stop or minimize blood loss. Medical teams can transfuse trauma patients with platelets to assist with blood coagulation if they are suffering from severe hemorrhage.

Pidcoke, the deputy task area manager of the Coagulation and Blood Research Program at the U.S. Army Institute of Surgical Research, is one of the researchers leading the charge.

"Down the line," she said, "extra 'life' from platelets could easily translate into fewer lives lost on the battlefield."

Statistics show that blood loss remains the number one cause of death on the battlefield, a problem further exacerbated by the fact that up until the recent protocol change by the FDA only room-temperature platelets were allowed for use in trauma patients. Room-temperature platelets are stored for up to five days due to risk of bacterial growth and hospitals must test them prior to transfusion. Cold storage allows clinicians to use platelets immediately, without testing.

"A bigger, better supply of platelets could reduce health care costs," said Kristin Reddoch, American Heart Association Graduate Research Fellow at the University of Texas, San Antonio.

In addition, Reddoch, who presented her findings during the same MHSRS session, also said emerging platelet additive solutions could extend the life of cold-store platelets for up to 15 days. Pidcoke says without any additional aid, studies show the presence of active and functional cold-stored platelets after 14 days.

"At the start of the war in Iraq, we had almost no platelets on the battlefield," said Pidcoke. "We can see a scenario where that won't be the case during the next conflict."

MHSRS is DOD's premier scientific annual meeting, which combines three previous conferences, including the former Advanced Technology Applications for Combat Casualty Care Conference; the Air Force Medical Service Medical Research Symposium; and the Navy Medicine Research Conference. By combining these conferences into one event, the meeting serves as a critical strategy session for leaders to set future milestones for the Department of Defense's deployment-related medical research programs, centered on the needs of the Warfighter.