Transfusion最新文献

{"title":"Outcomes on the use of hyperhemolysis prophylaxis in pediatric sickle cell disease patients with history of hyperhemolysis syndrome.","authors":"HyoJeong Han, Lisa Hensch, In Lei, Titilope Fasipe, Jun Teruya, Shiu-Ki Rocky Hui","doi":"10.1111/trf.18227","DOIUrl":"https://doi.org/10.1111/trf.18227","url":null,"abstract":"<p><strong>Background: </strong>Hyperhemolysis syndrome (HS) is a rare but severe transfusion-associated complication seen in patients with sickle cell disease (SCD). The management of HS includes avoidance of post-hyperhemolysis red blood cell (RBC) transfusion to avoid reoccurrence of HS (recurrent HS). However, complete avoidance of post-hyperhemolysis RBC transfusion (PHRT) is sometimes not clinically possible, and the standard of care for recurrent HS prophylaxis for patients requiring PHRT has not been established.</p><p><strong>Case report: </strong>We present a retrospective case series of four pediatric patients with SCD and a history of HS requiring PHRT, and describe their HS prophylaxis and outcomes. All patients received HS prophylaxis before transfusion, and three patients received an additional prophylactic regimen post-transfusion. Three patients were transfused with extended phenotype-matched RBCs, while one patient received only Rh (D, C/c, E/e) and K antigens matched RBCs. Only one patient did not develop recurrent HS after PHRT. Three patients had documented hemolysis, and two patients met our criteria for recurrent HS, all requiring escalation of care.</p><p><strong>Discussion: </strong>Even though the patients were treated in the same institution, there was variability in the choice of HS prophylaxis therapy and selection of RBCs, which can be attributed to the lack of guidance on PHRT management. We observed a lack of conclusive evidence in the effectiveness of prophylactic combination immunosuppressive therapy. Our observations suggest caution must be taken when transfusing patients with SCD and a history of HS, as there are no definitive therapies to effectively mitigate the risk of recurrent HS.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of oxygen extraction rate changes following red blood cell transfusion in the intensive care unit: A prospective observational noninterventional study.","authors":"Ahmet Salih Tüzen, Murat Aksun, Atilla Şencan, Senem Girgin, Birzat Emre Gölboyu, Gizem Kırbaş, Ozan Şanlı","doi":"10.1111/trf.18164","DOIUrl":"https://doi.org/10.1111/trf.18164","url":null,"abstract":"<p><strong>Background: </strong>The decision-making process for red blood cell transfusion (RBCT) in critically ill patients in the intensive care unit (ICU) remains primarily guided by hemoglobin-based thresholds. However, as a component of personalized medicine, innovative and individualized criteria should be developed to optimize RBCT decisions. This study aims to assess the impact of RBCTs on oxygenation parameters and patient outcomes, with a specific focus on the oxygen extraction ratio (O₂ER).</p><p><strong>Study design and methods: </strong>This prospective observational study included 77 critically ill patients receiving RBCTs according to ICU transfusion protocols. The primary hypothesis is that patients with an O₂ER > 0.30 will benefit most from RBCTs. To investigate this, patients receiving RBCTs were divided into two groups: those with O₂ER > 0.30 (RBCTs appropriate) and those with O₂ER ≤ 0.30 (RBCTs appropriateness questionable). The two groups were compared in terms of primarily O₂ER, other oxygenation parameters, and clinical outcomes. The primary outcome was the change in O₂ER following RBCTs, while secondary outcomes encompassed other oxygenation parameter changes.</p><p><strong>Results: </strong>The O₂ER > 0.30 group showed significant improvement in O₂ER (0.38 ± 0.04 vs. 0.32 ± 0.05; p < .001), whereas no such improvement was observed in the O₂ER ≤ 0.30 group (0.26 ± 0.03 vs. 0.28 ± 0.05; p: .017). Additionally, the O₂ER > 0.30 group exhibited improvements in central venous oxygen saturation (ScvO₂) following RBCTs, which were not seen in the O₂ER ≤ 0.30 group.</p><p><strong>Discussion: </strong>Our study reveals promising insights into the impact of RBCTs on O₂ER; however, these physiological changes did not result in significant clinical improvements. Hence, this study provides a rational basis for the feasibility of implementing a personalized strategy focused on physiological triggers for RBCTs.</p><p><strong>Trial registration number: </strong>NCT05798130 (https://clinicaltrials.gov/study/NCT05798130).</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finger thoracostomy: Significant risks and unproven benefits in prehospital settings.","authors":"Yael Mozer-Glassberg, Irina Radomislensky, Avi Benov, Ofer Almog","doi":"10.1111/trf.18198","DOIUrl":"https://doi.org/10.1111/trf.18198","url":null,"abstract":"<p><strong>Background: </strong>Trauma is a leading cause of preventable death, with a significant portion of trauma deaths occurring in the prehospital setting. Interventions such as chest drainage may play a critical role in managing life-threatening conditions but face challenges due to poorly defined indications and reliance on anecdotal evidence rather than rigorous studies. Among chest drainage techniques, finger thoracostomy (FT) is a well-described, but controversial, method for decompressing the pleural cavity in emergencies like tension pneumothorax or hemothorax. Despite its simplicity and minimal equipment requirements, FT carries risks, including bleeding, infection, organ injury, temporary effects, and procedural failure.</p><p><strong>Study design and methods: </strong>This study examines eight FT procedures performed by Israel Defense Forces providers during the 2023-2024 \"Swords of Iron\" War in Gaza.</p><p><strong>Results: </strong>All patients sustained severe penetrating injuries, with mixed outcomes. One case highlighted severe complications, including infection and empyema weeks later. Additionally, challenges in maintaining up-to-date knowledge and adherence to protocols among reservists led to unauthorized FT procedures, emphasizing the dangers of improvisation without evidence.</p><p><strong>Discussion: </strong>Our findings, coupled with limited evidence for FT's effectiveness in prehospital settings, raise questions about its appropriateness in trauma care. These concerns highlight the critical importance of adhering to validated and evidence-based protocols in all aspects of medical practice. Deviating from such protocols not only introduces unnecessary risks but also undermines the standardization essential for optimal patient care. Further research is needed to clarify the role, if any, of FT in prehospital trauma management.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel anticoagulant-preservative solution maintained the hemostatic function of cold stored whole blood for 56 days.","authors":"K M Reddoch-Cardenas, J A Cancelas, S Nestheide, N Rugg, K Peña, C S McIntosh, J Ferdin, J Talackine, J Parker, L A Jensen, R Gonzales, J R Hess, M Zia","doi":"10.1111/trf.18207","DOIUrl":"https://doi.org/10.1111/trf.18207","url":null,"abstract":"<p><strong>Background: </strong>Whole blood (WB) is an efficient product for field medical resuscitation because of its unitary composition, tolerance for storage on ice and in field refrigerators, and simplicity of use. We measured quality parameters of a novel 8-week WB storage system.</p><p><strong>Study design and methods: </strong>Here, 500 mL of WB from healthy donors was collected in 70 mL of CPDA-1, leukoreduced with a platelet-sparing filter, pooled into ABO-compatible two-unit pools, and split into matched pairs of equal volume designated as Test or Control units. Test units received an additional 50 mL of a novel WB preservative solution (APEX units, Hemerus Medical, St Paul, MN). A total of 15 paired WB units were evaluated at Day 0 (D0) and periodically up to Day 56 (D56) of storage at 1-6°C across two centers. Quality testing included cellularity, ATP concentrations, hemolysis, blood gases, metabolites, coagulation factor levels, thromboelastography (TEG), and bacterial culture.</p><p><strong>Results: </strong>At D56, APEX units displayed higher RBC ATP concentration (3.14 vs. 2.18 μmol/gHb, p = 0.001), pH (6.53 vs. 6.50, p = 0.01), and higher bicarbonate reserve (8 vs. 5.4, p < 0.0001). D56 APEX units had greater platelet contribution to TEG clot strength (p < 0.01) and better preservation of red cell ATP (p < 0.001). Activities of fibrinogen, factor VIII, factor V, and protein S activity in APEX units remained within the reference levels on D56. No bacterial contamination was detected at the end of storage.</p><p><strong>Discussion: </strong>These findings suggest that APEX preserves RBCs effectively and maintains platelet and plasma coagulation functions for up to 56 days.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exchange transfusion and pre-filter apheresis dilution for hyperviscosity syndrome refractory to conventional therapeutic plasma exchange in a patient with IgA multiple myeloma.","authors":"Anthony Valin-Thorburn, Sara-Maude Desforges, Daniel Corsilli, Jean-Gilles Guimond, Jean-Philippe Adam, Antonio Maietta, Bertrand Routy, Anne-Sophie Lemay","doi":"10.1111/trf.18188","DOIUrl":"https://doi.org/10.1111/trf.18188","url":null,"abstract":"<p><strong>Background: </strong>Significant serum paraprotein elevation leading to hyperviscosity syndrome (HVS) is a rare but serious medical complication that has been well documented in patients with hematological malignancies, including multiple myeloma and Waldenström's macroglobulinemia. This condition can result in severe neurological, renal, and cardiac complications. Standard management of symptomatic HVS includes therapeutic apheresis and the prompt initiation of chemotherapy. Although usually successful, apheresis failure due to extreme hyperviscosity has been documented.</p><p><strong>Case report: </strong>A 73-year-old Caucasian male with neurological symptoms of HVS secondary to IgA monoclonal gammopathy was transferred to our institution for urgent therapeutic plasma exchange (TPE) and HVS management. Due to severe hyperviscosity, it was impossible to obtain blood analysis, and several attempts at standard TPE failed due to clogging in the apheresis tubing. In this life-threatening situation, manual blood exchanges were successfully performed, followed by pre-filter apheresis dilution. This unconventional approach proved to be effective, allowing subsequent laboratory analysis and the continuation of conventional TPE procedures. The patient remained hemodynamically stable throughout the procedure and was subsequently started on definitive chemotherapy treatment.</p><p><strong>Conclusion: </strong>This case highlights the importance of prompt recognition of HVS in patients presenting with hematological malignancies. The use of manual exchange transfusion, in conjunction with pre-filter dilution, enabled the successful management of a patient with severe HVS in whom conventional TPE was not possible, illustrating an effective alternative approach in urgent hematological care. It also emphasizes the importance of initiating systemic treatment rapidly for the underlying hematological condition to ensure sustained improvement and prevent recurrence of HVS.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of time to death for children with life-threatening hemorrhage from traumatic, surgical, and medical etiologies.","authors":"Rachel P Vaizer, Christine M Leeper, Liling Lu, Cassandra D Josephson, Julie C Leonard, Mark H Yazer, Joshua B Brown, Philip C Spinella","doi":"10.1111/trf.18144","DOIUrl":"https://doi.org/10.1111/trf.18144","url":null,"abstract":"<p><strong>Introduction: </strong>Life-threatening hemorrhage (LTH) is a significant cause of mortality in pediatrics. Timing of mortality in children with LTH is important for future trials.</p><p><strong>Methods: </strong>In a secondary analysis of the prospective observational massive transfusion in children (MATIC) study, time-to-event analysis was performed to determine timing of death based on etiology of LTH and cause of death.</p><p><strong>Results: </strong>There were 449 children with LTH; the etiologies of LTHs included trauma (46%), operative (34%), and medical (20%). The cause of death at 24 h in the trauma group was 56% from hemorrhage and 42% from central nervous system (CNS) failure; in operative group it was 94% from hemorrhage and 6% CNS failure; in medical group it was 84% hemorrhage and 3% CNS failure. The median (interquartile range [IQR]) time to death (hours) varied by cause of death (hemorrhagic: 3.3 [1.0-10.3], CNS failure: 30.4 [9.0-63.6]). For traumatic LTH, 90% of hemorrhage-related deaths occurred within 19 h and 90% of CNS failure deaths occurred within 92 h. For operative LTH, 90% of hemorrhage-related deaths occurred within 5 days and 90% of CNS failure deaths occurred within 28 days. For medical LTH, 90% of hemorrhage-related deaths occurred within 44 h and 90% of CNS failure deaths occurred within 24 days.</p><p><strong>Conclusion: </strong>In children, timing of death differs according to etiology of LTH and by cause of death. The choice of primary outcome for trials in children with LTH should consider these differences based on the etiology of LTH being studied.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drawing and storing whole blood using a 3D printed bottle cap and a disinfected 500 mL drinking bottle-A proof-of-concept study: Part 2.","authors":"Martin Rognhaug, Hanne Braathen, Håkon Skogrand Eliassen","doi":"10.1111/trf.18200","DOIUrl":"https://doi.org/10.1111/trf.18200","url":null,"abstract":"<p><strong>Background: </strong>Disruptions in supply chains during crises and wars necessitate innovative solutions for blood collection. This study evaluates the feasibility and safety of using a 3D-printed bottle cap (BC²L) with a standard 500 mL drinking bottle for whole blood collection as an alternative to traditional systems.</p><p><strong>Study design and method: </strong>We conducted a feasibility study with 20 healthy adult volunteers. Participants were randomized to donate blood into either the BC²L-drinking bottle setup (Test) or a conventional single blood collection bag (control). Blood samples were analyzed for hemolysis, bacterial contamination, and mechanical integrity immediately post-donation, and at 24 and 72 h. Donation time and donor safety were also assessed. Bacterial growth testing and hematological analyses followed sterile procedures to measure hematological quality.</p><p><strong>Results: </strong>Blood collection was completed within a mean time of 7 min across both groups. Hemolysis levels remained below clinically significant thresholds in both setups, and no bacterial contamination was observed. While the BC²L system demonstrated effective blood collection, minor leakage was noted in some bottles during transportation, attributed to the limitations of the 3D-printing process.</p><p><strong>Conclusion: </strong>The BC²L system represents a feasible, low-cost alternative for whole blood collection in resource-limited or crisis settings. It demonstrated comparable safety and mechanical integrity to standard systems. However, manufacturing refinements are needed to address leakage during transport. This study supports the potential of the BC²L as a valuable tool for enhancing medical preparedness in austere environments.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of a novel variant (c.1-111A>G) located in GATA-1 motif of RHCE proximal promoter in two Chinese patients with the rare D-- phenotype.","authors":"Ran Zhang, Jizhi Wen, Changjiu Tang, Shuangshuang Jia, Qi Chen, Yanli Ji","doi":"10.1111/trf.18223","DOIUrl":"https://doi.org/10.1111/trf.18223","url":null,"abstract":"<p><strong>Background: </strong>D-- is a rare phenotype lacking the expression of the C, c, E, and e antigens and several high-frequency antigens on the red cells. Anti-Rh17 (Hr0) could be developed in individuals with the D-- phenotype to cause hemolytic transfusion reactions (HTR) and hemolytic disease of the fetus and newborn (HDFN). Nuleotide(s) change of the RHCE gene and RHCE-D-CE hybrid alleles are the common molecular basis of the D-- phenotype.</p><p><strong>Study design and methods: </strong>One D-- Chinese patient detected in routine RhD and RhCE serologic testing and another D-- Chinese patient identified with anti-Rh17 were recruited. Further RHD, RHCE, and RHAG whole gene sequences were analyzed using the PacBio sequencing. A dual-luciferase reporter assay was performed to verify the effect of the variant identified in the promoter of the RHCE gene on the transcriptional activity of the reporter gene in vitro.</p><p><strong>Results: </strong>A homozygous RHCE*Ce(1-111G)/Ce(1-111G) genotype and a heterozygous RHCE*CeN.08/Ce(1-111G) genotype carried one novel variant (c.1-111A>G) located in the GATA-1 motif of the RHCE proximal promoter was identified in two D-- patients, respectively. In the reporter assay, the luciferase transcriptional activity of the mutant RHCE promoter [c.1-111G] construct reduced from ~1.0 to 0.28 relative luciferase activity normalized to RHCE wild-type, with a ~72% reduction rate.</p><p><strong>Conclusion: </strong>The novel variant of the GATA-1 motif of the RHCE proximal promoter was identified to diminish the binding of the GATA-1 transcription factor and markedly down-regulate the transcription activity of the RHCE gene to abolish the expression of RhCE antigens, causing the rare D-- phenotype.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramuscular vasopressin: A feasible intervention for prehospital hemodynamic stabilization in porcine hemorrhagic shock and whole blood transfusion.","authors":"Mattias Renberg, Tomas Karlsson, Mikael Gellerfors, Jenny Gustavsson, Katrin Wellfelt, Mattias Günther","doi":"10.1111/trf.18218","DOIUrl":"https://doi.org/10.1111/trf.18218","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhagic shock is the leading cause of preventable prehospital trauma deaths. While arginine vasopressin (AVP) is a well-known hormone with vasopressor effects, its potential for hemodynamic stabilization in prehospital hemorrhagic shock remains underexplored. This study investigated intramuscular (IM) AVP during hemorrhagic shock to evaluate its feasibility and efficacy for prehospital trauma resuscitation.</p><p><strong>Study design and methods: </strong>In this randomized, controlled, double-blinded trial, 16 swine (mean [standard deviation, SD] weight 56.2 [3.8] kg) underwent a mean (SD) 1205 (124) mL Class III hemorrhage for 45 min and 45 min of hypotension. Animals were randomized to 40 U IM AVP (n = 7) or NaCl (n = 9), followed immediately by 500 mL autologous whole blood transfusion over 30 and 120 min posttransfusion monitoring of hemodynamic, respiratory, and metabolic parameters.</p><p><strong>Results: </strong>AVP increased systolic arterial pressure 30 min after administration (mean increase: 33.5 mmHg vs. 7.5 mmHg, p < 0.05) and improved cardiac index (CI) 90 min after AVP (mean increase: 19.2% vs. 4.1% decrease, p < 0.05) and stroke volume (mean increase: 37.0% vs. 1.0%, p < 0.05). These effects normalized by 120 min. AVP did not affect respiratory parameters, oxygen delivery, or consumption. Increased serum AVP confirmed systemic uptake (median 68.7 pg/mL vs. 10.0 pg/mL in controls, p < 0.05).</p><p><strong>Conclusion: </strong>IM AVP, combined with whole blood transfusion, transiently stabilized hemodynamics by increasing systemic vascular resistance index, systolic blood pressure, and CI without respiratory compromise. These findings suggest that IM AVP may be a viable intervention for prehospital resuscitation of severe hemorrhagic shock, offering vital short-term stabilization to facilitate transport to definitive care.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of cold-stored platelets using Golden Hour transport boxes: Function and quality.","authors":"Jamie Nash, Christine Saunders, Nicola Pearce, Michael Cahillane, Edward J Sayers, Victoria Stokes, David Rawlinson, Christopher Hingston, Tom Scorer, David Lockey, Chloe George","doi":"10.1111/trf.18197","DOIUrl":"https://doi.org/10.1111/trf.18197","url":null,"abstract":"<p><strong>Background: </strong>The Emergency Medical Retrieval and Transfer Service in Wales provides prehospital critical care, including the transfusion of red blood cells and plasma. However, the logistical challenges of storing platelet concentrates (PCs) at 22°C with constant agitation limit their prehospital use. Cold-stored platelets (CSP) at 4°C without agitation offer a potential solution, demonstrating superior hemostatic capabilities in vitro and longer storage potential. This study investigated the viability of storing CSP in Golden Hour boxes for up to 96 h, followed by refrigeration, to enhance prehospital damage control resuscitation.</p><p><strong>Methods: </strong>Two buffy-coat-derived PCs were combined and split into two: one PC was refrigerated at 4°C ± 2°C without agitation (CSP) for 15 days, and the other was stored in a Golden Hour cold box from days 2 to 6 (GH-CSP) before being rotated back into refrigeration. In vitro assessments included aggregometry, thrombin generation, thromboelastography, and platelet activation via P-selectin and annexin V binding.</p><p><strong>Results: </strong>Temperature data demonstrated that a Golden Hour box can maintain a temperature of 2-6°C for up to 84 h with a CSP and two red cell concentrates. Platelet function was not significantly different between the two storage conditions. GH-CSP displayed increased annexin V binding on day 8 compared with CSP (32.31 ± 3.27% vs 26.36 ± 2.17%, p = .0026) and day 15 (41.76 ± 6.13% vs 38.41 ± 3.99%, p = .0199).</p><p><strong>Conclusion: </strong>CSP stored in a Golden Hour box was comparable with conventional CSP, suggesting this method may be viable for prehospital use.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}