A small change helps donated platelets last longer
A small change in the way Cape Cod Hospital handles donated platelets could make a big difference for local patients who are undergoing cancer treatment or suffer a traumatic injury.
“This allows us to extend the expiration of a unit of donated platelets from five days to seven days,” said Jonathan DeCoste, senior blood donor recruiter at Cape Cod Healthcare. “Extending the life allows for longer product availability and better inventory control over the weekend when there are no collections.”
Platelets are tiny cells that form clots and stop bleeding. Platelet donation is different from regular donation in that blood is removed via the arm, a machine extracts just the platelets, and the rest of the blood is returned back to the bloodstream.
Platelet storage is also different from red blood cells, which can be preserved for 42 days when refrigerated between 1 and 6 degrees Celsius (33.8 to 42.8 degrees Fahrenheit).
“Platelets have to be stored at room temperature in order to maintain their function,” said Lok Tse, supervisor of the Transfusion Medicine Services and Blood Donor program for Cape Cod Healthcare. “When you store platelets at room temperature, there's an increased risk of bacterial contamination, or bacteria growth.” Bacterial residual risk per transfused unit is estimated at about one in 2,500, he added.
Before the change in FDA guidelines, the platelets were held for 24 hours and then a sample was inoculated in a culture bottle and monitored for bacteria growth for five days. If there is no bacteria growth at 24 hours, the platelets could be labeled for use within five days from collection.
Under the new process, the sample isn’t inoculated until 48 hours after the donation and monitored for bacterial growth for seven days. If there is no bacterial growth detected at 12 hours after inoculation, the platelets can be labeled for use for seven days from collection.
Nationwide, approximately two million units of platelets are transfused annually, Tse said. Cape Cod Healthcare performs 800 platelet transfusions a year at its hospitals in Hyannis and Falmouth.
“Platelet transfusions are needed mainly for oncology patients,” he said. “We also have patients undergoing surgery, especially cardiac surgery, who need platelet transfusions. And then we have trauma patients who come in due to car accidents or shark attacks, stabbing or shootings.
“Our goal is to decrease platelet wastage due to the outdate. Platelets have a short shelf life, so we have to constantly replenish our supply. By extending the shelf life of the platelets, we have additional time to give it to patients who may need it to survive.”
The process for donors is unchanged. It still takes about 90 minutes to two hours to donate platelets. Donors can donate platelets every two weeks.
“It's not painful. Basically, it's a needle stick, like a phlebotomy,” Tse said. “You sit in a chair and can watch a movie, read a book or make phone calls.”
For information about donating platelets, contact the Nicholas G. Xiarhos Blood Donor Center at 508-86BLOOD (508-862-5663).