Transfusion experience with platelet concentrates stored for 24 to 72 hours at 22° C

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Abstract
The transfusion response from random donor platelet concentrates was studied in 15 stable, multitransfused, thrombocytopenic patients by comparing the platelet counts measured before and 20 h after transfusion. The observed platelet increments were corrected (corrected increment, C.I.) for the number of units of platelet concentrate transfused and the patient''s body surface area in m2 (platelets/.mu.l/unit/m2). Using platelet concentrates stored for less than 24 h, the patients achieved a median C.I. of 9500 (range: 5000-18,000). When platelet concentrates stored for 24-48 h or 48-72 h were given, the median C.I. markedly decreased to 1000 (range: 0-4800) and 0 (range: 0-5100), respectively (P < 0.001). These differences could not be explained by further recipient alloimmunization. Transfusion with platelet concentrates less than 24 h old on a 2nd occassion, bracketing the transfusions of older platelet concentrates, resulted in a median C.I. of 7200 (range: 5400-14,500). Similar results were obtained in 3 patients when HLA-identical sibling platelet concentrates were employed. In vitro tests, including pH, morphology and aggregation, demonstrated no statistically significant differences among the platelet concentrates stored for less than 24 h, 24-48 h, and 48-72 h. Although platelet concentrates can be stored for 72 h without loss of in vitro function, the in vivo recovery is significantly diminished after 24 h of storage. Patients should not be transfused prophylactically with platelet concentrates greater than 24 h old.