PB0894 - Evaluating platelet function post transfusion with cold-stored vs room temperature platelets in patients with traumatic brain injury

Monday, June 26, 2023

18:30 – 19:30 ET

Room: Exhibition

Co-Author(s)

LH

Lara Hoteit, MD

Postdoctoral Research Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States

Co-Author(s)

Amudan J. Srinivasan, MD

Surgical Critical Care Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
Devin M. Dishong

Research Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
Emily P. Mihalko, PhD

Research Scientist
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
RK

Ronit Kar

Research scholar
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
NA

Nijmeh Alsaadi

Postdoctoral Research Fellow
Trauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
DO

David O. Okonkwo

Professor of Neurological Surgery
Department of Neurosurgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
JS

Jason L. Sperry

Professor of Surgery
Department of Surgery, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
SS

Susan M. Shea

Assistant Professor of Surgery and Bioengineering
Department of Surgery, Department of Bioengineering, University of Pittsburgh
Pittsburgh, Pennsylvania, United States

Presenting Author(s)

Matthew D. Neal, MD FACS (he/him/his)

Associate Professor
University of Pittsburgh
Pittsburgh, Pennsylvania, United States

Background: Traumatic brain injury (TBI) patients on antiplatelet therapy are often transfused platelets to improve outcomes. Previous studies suggest Room temperature-stored platelets (22C, RT-PLT) have little benefit when given to TBI patients, due to either the insufficient availability, leading to low dosing, and/or poor hemostatic function. Use of cold-stored platelets (4C, CS-PLT) may correct both limitations.

Aims: Compare platelet function after transfusion with RT- or CS-PLT in patients with TBI.

Methods: Blood drawn from patients with TBI on aspirin therapy (n=41), before and after platelet transfusion with RT- or CS-PLT, was assayed using the following tests: VerifyNow, rapid thromboelastography (TEG), whole blood aggregometry, and flow cytometry. These data were collected as part of an ongoing randomized controlled trial comparing RT- and CS-PLT. Statistical comparisons were made using ANOVA or mixed model with Sidak post-hoc testing.

Results: VerifyNow results show that room temperature platelets significantly increase Aspirin Response Units (from a mean response unit of 437.4 to 560.7; p-value = 0.0005) (Figure 1.A). RT-PLT improved the response of platelets to arachidonic acid on impedance platelet aggregometry (from a mean AUC of 0.98 to 31.1 post-transfusion; p-value = 0.0002) (Figure 1.B). Platelet transfusion, regardless of temperature, did not change platelet activation in response to agonists (arachidonic acid, ADP) (Figure 1.C). TEG platelet mapping maximal amplitude with arachidonic acid significantly increased after transfusion with both room and cold temperature platelets (27.5mm to 37.5mm with cold temperature platelets, p-value = 0.045; 26.2mm to 38mm with room temperature platelets, p-value = 0.0137) (Figure 1.D).

Conclusion(s): All assays showed an equal performance of cold stored and room temperature platelets, except for the VerifyNow Aspirin test and impedance platelet aggregometry, where RT-PLT outperformed CS-PLT. Further analysis is needed to assess effects on clinical outcomes, and to generate adjusted statistical models with clinical data.