Perioperative Platelet Transfusions

Aaron Stansbury Hess, M.D., Ph.D.; Jagan Ramamoorthy, M.D.; John Rider Hess, M.D., M.P.H.


Anesthesiology. 2021;134(3):471-479. 

In This Article

"Cold" Platelets, Whole Blood, and Other Uncommon Platelet Products

"Cold" platelets are platelets stored at 4°C instead of the conventional 22°C. Cold platelets are cleared from the circulation more rapidly than conventional platelets, but may have greater immediate hemostatic efficacy.[22–25] Trials of cold-stored platelets in cardiac surgery and other clinical scenarios are ongoing. Whole blood for transfusion contains red cells, plasma, and platelets; is stored cold at 4°C; and is increasingly common in civilian trauma resuscitation.[26] Platelet counts after whole blood transfusion in bleeding patients are comparable to those obtained with balanced multicomponent resuscitation.[27] In centers where it is available, it is common to begin resuscitation with whole blood and then switch to laboratory-guided component therapy after major bleeding is controlled.[28] Other products also exist, such as frozen or lyophilized platelets, but these are not licensed in the United States.