Which is the best storage temperature to preserve the haemostatic quality of non-leukoreduced whole blood units collected under a military emergency protocol - Cold or room temperature?

Abstract

Objectives: Emergency collection may be the only way to access blood when an urgent need arises, such as in a military setting. However, it is important to preserve any excess whole blood donations for future transfusion needs. Cold or room temperature (RT) storage has been reported in the literature. This raises the question of which storage temperature best preserves haemostatic properties of whole blood (WB). Our study investigated this question for storage times up to 48 h.

Methods: This comparison study used 30 bags of WB collected from eligible military personnel. WB bags were randomly stored at either 22 °C or 4 °C. Samples from each bag were taken immediately after blood collection and analysed again after 48 h storage. Analyses included: metabolic and haematological parameters, coagulation factors, thrombin generation potential and platelet function (platelet activity, clotting capacity and aggregometry).

Results: The overall quality of both storage conditions at 48 h was adequate according to metabolic parameters. Aggregometry was significantly affected in both groups. Clot stiffness was better preserved in WB stored at RT, however coagulation time was extended compared to storage at 4 °C. The platelet count was reduced in 4 °C. The thrombin generation potential was maintained irrespective of storage conditions.

Conclusion: The storage at RT offers encouraging in vitro results to promote its use to recover haemostatic functions. As both conservation temperature is acceptable, this will offer greater flexibility to access blood in a resource-limited environment. The choice of either temperature should depend on the frequency of patient admissions.