BACKGROUND The short shelf‐life of fresh platelets limits their efficient inventory management and availability during a massive transfusion protocol. Risk of insufficient availability can be mitigated by building an inventory of cryopreserved platelets (CPs). METHODS A comparative study of fresh apheresis platelets (FAPs) and CPs was performed. Type‐O CPs were processed with DMSO frozen at −80°C and reconstituted in thawed AB plasma. All patients enrolled in the study had the following parameters evaluated on admission: vital signs (body temperature, heart rate, mean arterial pressure), blood count, prothrombin time, activated partial thromboplastin time, fibrinogen level, and, in trauma patients, international severity score. Several outcomes were evaluated: 30‐day survival, adverse events, quantity of administered blood products, fibrinogen concentrate and thromboxane (TXA), and laboratory parameters after transfusion (blood count, prothrombin time, activated partial thromboplastin time, fibrinogen level). RESULTS Twenty‐five (25) patients in the study group received transfusions totaling 81 units of CPs. Twenty‐one (21) patients in the control group received a total of 67 units of FAPs. There were no significant differences in patient characteristics (p > 0.05) between groups. Both groups were comparable in clinical outcomes (30‐day survival, administered blood products, fibrinogen concentrate, TXA, and adverse events). Among posttransfusion laboratory parameters, platelet count was higher in the group transfused with FAPs (97.0 ×109/L) than in the group transfused with CPs (41.5 ×109/L), p = 0.02025. Other parameters were comparable in both groups. CONCLUSION The study suggests that CPs are tolerable and a feasible alternative to FAPs. However, larger randomized studies are needed to draw definitive conclusions.

Question 4Cryopreserved platelets are currently stored at -65 to -90°C (-80°C) in a mechanical freezer. A frozen shelf life of 2 years has been applied for platelets for the CLIP trial and for the Australian Defence Force. We have allocated a post-thaw shelf life of 6 h for platelets for the Australian Defence Force to minimize risk of bacterial growth. This is

BACKGROUND Determination of blood donor hemoglobin (Hb) levels is a pre‐requisite to ensure donor safety and blood product quality. We aimed to identify Hb measurement practices across blood donation services and to what extent differences associate with low‐Hb deferral rates. METHODS An online survey was performed among Biomedical Excellence for Safer Transfusion (BEST) Collaborative members, extended with published data. Multivariable negative‐binomial regression models were built to estimate adjusted associations of minimum donation intervals, Hb cut‐offs (high, ≥13.5 g/dL in men or ≥ 12.5 g/dL in women, vs. lower values), iron monitoring (yes/no), providing or prescribing iron supplementation (yes/no), post‐versus pre‐donation Hb measurement and geographical location (Asian vs. rest), with low‐Hb deferral rates. RESULTS Data were included from 38 blood services. Low‐Hb deferral rates varied from 0.11% to 8.81% among men and 0.84% to 31.85% among women. Services with longer minimum donation intervals had significantly lower deferral rates among both women (rate ratio, RR 0.53, 95%CI 0.33‐0.84) and men (RR 0.53, 95%CI 0.31‐0.90). In women, iron supplementation was associated with lower Hb deferral rates (RR 0.47, 95%CI 0.23‐0.94). Finally, being located in Asia was associated with higher low‐Hb deferral rates; RR 9.10 (95%CI 3.89‐21.27) for women and 6.76 (95%CI 2.45‐18.68) for men. CONCLUSION Differences in Hb measurement and eligibility criteria, particularly longer donation intervals and iron supplementation in women, are associated with variations in low‐Hb deferral rates. These insights could help improve both blood donation service efficiency and donor care.

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Whole blood is the original blood preparation but disappeared from the blood bank inventories in the 1980s following the advent of component therapy. In the early 2000s, both military and civilian practice called for changes in the transfusion support for massive haemorrhage. The ‘clear fluid’ policy was abandoned and replaced by early balanced transfusion of platelets, plasma and red cells. Whole blood is an attractive alternative to multi‐component therapy, which offers reduced hemodilution, lower donor exposure and simplified logistics. However, the potential for wider re‐introduction of whole blood requires re‐evaluation of haemolysins, storage conditions and shelf‐life, the need for leucocyte depletion/ pathogen reduction and inventory management for blood providers. This review addresses these questions and calls for research to define the optimal whole blood product and the indications for its use.