Overview of current and alternative platelet products
| Product . | Donors . | Collection . | Modifications . | Storage . | Storage duration . | (Planned) indication . | Bacterial growth risk . | Volume (mL) . | Preparation . | Summary . |
|---|---|---|---|---|---|---|---|---|---|---|
| RT-stored platelets (standard of care) | Regular donor restrictions | Apheresis/phlebotomy | Pathogen reduction, leukoreduction, irradiation, additive solutions, volume reduction | Liquid 20° to 24°C | 5-7 d | Prophylactic/therapeutic (current standard of care) | High (∼1:1000-3000)141 | 200-250 | N/A | Pro: Best in vivo recovery and survival Con: Short shelf life, bacterial growth, low in vitro quality |
| CSPs | Regular donor restrictions | Apheresis/phlebotomy | Additive solutions, leukoreduction | Liquid 1° to 6°C | 3 d, 14 d* | Therapeutic | Low143,144 | 200-250 | N/A | Pro: Extended shelf life, preserved in vitro quality Con: reduced in vivo recovery and survival, in vivo hemostatic function uncertain? |
| Cold-stored whole blood | Group O, low titer anti-A/B, possibly males only | Phlebotomy | Leukoreduction | Liquid 1°C to 6°C | 21 d (CPD), 35 d (CPDA-1) | Therapeutic (especially outside of hospital, trauma) | Low142 | 500 | N/A | Pro: Extended shelf life, includes all blood components Con: Possible ABO, Rh mismatch, lower recovery and survival, lower platelet dose, in vivo platelet function uncertain |
| CPPs | Regular donor restrictions | Apheresis/phlebotomy | Leukoreduction, resuspension in saline or plasma | Solid/frozen, −80°C | 3 y (≥5 y reported) | Therapeutic | Perceived to be very low16 | 20-50 | Thawing and resuspension† | Pro: Extended shelf life (years), almost normal in vivo survival, most in vivo performance data Con: logistics (freezer, thawing, preparation) |
| Freeze-dried (lyophilized) platelets‡ | Group O | Apheresis | Leukoreduction | Solid/powder, RT | 3 y | Therapeutic (especially outside of hospital, military) | Perceived to be very low (including pathogen reduction and culture)134 | 30-50 | Reconstitution in sterile water | Pro: Extended shelf life (years), logistics Con: reduced in vitro function, in vivo hemostatic function uncertain |
| Product . | Donors . | Collection . | Modifications . | Storage . | Storage duration . | (Planned) indication . | Bacterial growth risk . | Volume (mL) . | Preparation . | Summary . |
|---|---|---|---|---|---|---|---|---|---|---|
| RT-stored platelets (standard of care) | Regular donor restrictions | Apheresis/phlebotomy | Pathogen reduction, leukoreduction, irradiation, additive solutions, volume reduction | Liquid 20° to 24°C | 5-7 d | Prophylactic/therapeutic (current standard of care) | High (∼1:1000-3000)141 | 200-250 | N/A | Pro: Best in vivo recovery and survival Con: Short shelf life, bacterial growth, low in vitro quality |
| CSPs | Regular donor restrictions | Apheresis/phlebotomy | Additive solutions, leukoreduction | Liquid 1° to 6°C | 3 d, 14 d* | Therapeutic | Low143,144 | 200-250 | N/A | Pro: Extended shelf life, preserved in vitro quality Con: reduced in vivo recovery and survival, in vivo hemostatic function uncertain? |
| Cold-stored whole blood | Group O, low titer anti-A/B, possibly males only | Phlebotomy | Leukoreduction | Liquid 1°C to 6°C | 21 d (CPD), 35 d (CPDA-1) | Therapeutic (especially outside of hospital, trauma) | Low142 | 500 | N/A | Pro: Extended shelf life, includes all blood components Con: Possible ABO, Rh mismatch, lower recovery and survival, lower platelet dose, in vivo platelet function uncertain |
| CPPs | Regular donor restrictions | Apheresis/phlebotomy | Leukoreduction, resuspension in saline or plasma | Solid/frozen, −80°C | 3 y (≥5 y reported) | Therapeutic | Perceived to be very low16 | 20-50 | Thawing and resuspension† | Pro: Extended shelf life (years), almost normal in vivo survival, most in vivo performance data Con: logistics (freezer, thawing, preparation) |
| Freeze-dried (lyophilized) platelets‡ | Group O | Apheresis | Leukoreduction | Solid/powder, RT | 3 y | Therapeutic (especially outside of hospital, military) | Perceived to be very low (including pathogen reduction and culture)134 | 30-50 | Reconstitution in sterile water | Pro: Extended shelf life (years), logistics Con: reduced in vitro function, in vivo hemostatic function uncertain |