Effect of cold storage on shear-induced platelet aggregation and clot strength

Prajeeda M. Nair, Heather F. Pidcoke, Andrew P. Cap, Anand K. Ramasubramanian*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

72 Scopus citations


BACKGROUND: Platelets (PLTs) participate in hemostasis and save lives following trauma. PLTs for transfusion are maintained at room temperature (RT, 22°C), limiting viability to 5 days because of metabolic compromise and high risk of bacterial contamination. RT storage may result in weaker clots, delaying hemorrhage control, whereas cold storage (4°C) could permit longer PLT shelf life and result in a more hemostatic product. In this study, we characterized the effect of storage temperature on shear-induced PLT aggregation, clot formation, and strength. METHODS: PLTs obtained from phlebotomized blood or by apheresis were stored at RT or 4°C for 5 days, and PLT aggregation and clot strength were assessed at 37°C. We studied PLT aggregation at steady and complex patterns of shear rates (500-2,500 per second) by flow cytometry, and the kinetics of clot formation and strength were measured using turbidity and dynamic mechanical analysis, respectively. RESULTS: PLT aggregation was higher in 4°C-stored samples on Day 5 compared with fresh or RT-stored samples at all shear rates tested (fresh vs. 4°C and RT vs. 4°C, p < 0.05). PLTs stored at 4°C for 5 days formed significantly stronger clots compared with fresh or RT-stored samples as quantified by turbidity and elastic moduli measurements (fresh vs. 4°C and RT vs. 4°C, p < 0.05). CONCLUSION: Our results show that cold-stored PLTs are more responsive to aggregation stimuli and form stronger clots, presumably because of thicker fibrin strands. These data suggest that the superior functionality of cold-stored PLTs may support faster hemostasis for acutely bleeding in trauma patients compared with RT-stored PLTs.

Original languageEnglish
Pages (from-to)S88-S93
JournalJournal of Trauma and Acute Care Surgery
Issue number3 SUPPL. 2
StatePublished - 2014
Externally publishedYes


  • Platelet storage
  • SIPA
  • clot strength
  • hemorrhage
  • refrigeration


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