Response of platelet concentrates to pressure and temperature changes without impairment of the in vitro function

Background: Rapid platelet concentrate (PC) transfusion is crucial for hemostatic resuscitation. Pressure-aided and warmed transfusion combined with pneumatic tube system (PTS) transport from the laboratory to the operating theatre offers a potentially rapid delivery technique. The aim of this study is a quantitative assessment of in vitro platelet function after PTS transport followed by warmed and/or pressure-aided mock transfusions. Methods: Ten PC samples entered a single PTS run and were subsequently aliquoted for testing. PCs were warmed in a blood warmer and/or subjected to pressure-aided mock transfusion at 300 mm Hg on day 2 or day 7 after collection. Platelet function was assessed using light-transmission aggregometry and multiple-electrode aggregometry to measure the response to ADP, arachidonic acid, collagen, and thrombin-receptor activating peptide. Data were analyzed with non-parametric testing; P <0.05 was considered statistically significant. Results: Single PTS transport markedly reduced ADP response in fresh PCs. Seven-day storage had a pronounced effect on both ADP and collagen response. All other tested platelet agonists revealed preserved function. Subsequent warming and/or application of pressure did not significantly compromise platelet function. Conclusions: Pressure-aided plus warmed transfusion and PTS transport was not found to be detrimental to the PC. Further clinical studies are required to determine safety and efficacy of the product.