With the outbreak of COVID-19 maintaining adequate inventory levels for platelet concentrates may be even more challenging than ever.
Applying pathogen inactivation technologies to platelet concentrates can extend their shelf life from 5 to 7 days*, but there have been few systematic studies of the repercussions of such technologies on outdate rates, clinical efficacy and safety.
Outdating rates
Findings from recent published Spanish studies1 indicate that if a reasonable production policy is followed then a shift from 5 to 7 days enables outdates to be almost entirely eliminated (the reductions obtained range from 88% to 100%).
Also, a subsequent reduction in outdating at hospitals are to be expected as platelet concentrates arrive at hospitals with almost two more days of remaining life time.
Clinical efficacy and safety
The University Hospital Basel recently published results of a large retrospective two-cohort study2 which looked at clinical efficacy and safety of INTERCEPTTM treated platelet concentrates stored for up to 7 days.
Transfusion of pathogen inactivated platelet concentrates more than 5 days old compared with 5 days old or less did not increase platelet concentrates and RBC use on the same or next day as an indirect measure of hemostasis and did not increase transfusion reactions.
Mean number of platelet concentrates used per patient and duration of support were not different for hematology/oncology, allogeneic and autologous hematopoietic stem cell transplant, and general medical/surgical patients.
Routine use
INTERCEPTTM Blood System treated platelet concentrates stored for more than 5 days have been transfused in Sweden, Spain, Belgium, Iceland, Portugal, and Switzerland. In April 2018, the French health authority, Agence Nationale de Sécurité du Médicament et des Produits de Santé, approved shelf life extension to 7 days.
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*The extension of platelet storage time might be subject to local regulations and may not be available in your country.
Reference:
1Carlos Gorria et all, Impact of implementing pathogen reduction technologies for platelets on reducing outdates, Vox Sanguinis
(2019), DOI: 10.1111/vox.12860
2Laura Infanti et all; Clinical impact of amotosalen-ultraviolet A pathogen-inactivated platelets stored for up to 7 days; TRANSFUSION 2019;9999;1–12
