Hemostatic function of cold-stored platelets in a thrombocytopenic rabbit bleeding model

Animal models of hemorrhage, parameters, and development of hemostatic methods

Hemorrhage is a prevalent side effect of various injuries and can be life-threatening in certain instances. It is categorized into compressible and non-compressible types, each necessitating distinct modeling, laboratory assessments, and hemostatic approaches. This study utilized the keywords Hemorrhage, Bleeding, Animal Modeling, and Hemostat in reputable databases. The findings indicate that femoral artery hemorrhage and hepatic parenchymal hemorrhage are the predominant modeling techniques for compressible and non-compressible bleeding, respectively. Furthermore, it is noted that animal models of compressible hemorrhages are primarily situated in superficial body areas to investigate dressing or additive hemostats, while non-compressible hemorrhage models, typically located in visceral organs, are employed to examine adhesive or surgical instrument-based hemostats.

Bacterial Contamination of Platelet Products

Transfusion of bacterially contaminated platelets, although rare, is still a major cause of mortality and morbidity despite the introduction of many methods to limit this over the past 20 years. The methods used include improved donor skin disinfection, diversion of the first part of donations, use of apheresis platelet units rather than whole-blood derived pools, primary and secondary testing by culture or rapid test, and use of pathogen reduction. Primary culture has been in use the US since 2004, using culture 24 h after collection of volumes of 4-8 mL from apheresis collections and whole-blood derived pools inoculated into aerobic culture bottles, with limited use of secondary testing by culture or rapid test to extend shelf-life from 5 to 7 days. Primary culture was introduced in the UK in 2011 using a "large-volume, delayed sampling" (LVDS) protocol requiring culture 36-48 h after collection of volumes of 16 mL from split apheresis units and whole-blood derived pools, inoculated into aerobic and anaerobic culture bottles (8 mL each), with a shelf-life of 7 days. Pathogen reduction using amotosalen has been in use in Europe since 2002, and was approved for use in the US in 2014. In the US, recent FDA guidance, effective October 2021, recommended several strategies to limit bacterial contamination of platelet products, including pathogen reduction, variants of the UK LVDS method and several two-step strategies, with shelf-life ranging from 3 to 7 days. The issues associated with bacterial contamination and these strategies are discussed in this review.