“…The heightened aggregation of 4-C-stored platelets under shear conditions may be attributable to two complementary mechanisms. 20,21,38,39 The rates of gelation between fresh and 4-C-stored samples were comparable, suggesting that the factors contributing to fibrin polymerization, namely, fibrinogen levels, plasma factors such as factor XIII or plasminogen activation inhibitors, and thrombin generation by platelets, are preserved during cold storage. 7,33,36 Second, because cold storage partially activates platelets, either as described earlier or via other mechanisms, and low temperature generally preserves the internal enzymatic machinery in cells, the platelets are thus ''primed'' for a maximal response to shear forces.…”