The use of lyophilized platelets in veterinary medicine | VETgirl Veterinary Continuing Education Videos
In this VETgirl online veterinary continuing education video, we discuss the use of lyophilized platelets in veterinary medicine. Patients presenting with a severe, life-threatening thrombocytopenia (in VETgirl’s opinion, < 20,000/μL] are at risk for clinical signs of bleeding. With any thrombocytopenic patient, concurrent workup and treatment should be implemented to rule out underlying causes of immune-mediated thrombocytopenia, neoplasia, disseminated intravascular coagulation, etc. With ITP, treatment typically includes immunosuppressives (e.g., steroids, cyclosporine), supportive care, and therapy to minimize complications (e.g., gastric protectants, antacids, anti-thrombotics, etc.).
With life-threatening bleeds (e.g., central nervous system bleeding, etc.) or in patients with severe thrombocytopenia needing to undergo invasive procedures, the use of freeze dried (e.g., lyophilized) platelets can be considered. The benefit of lyophilized platelets is that they have storage advantages over fresh platelet concentrates (e.g., they can be stored for up to 24 months in the refrigerator); also, fresh platelet concentrates are not readily available to veterinarians. Activated platelets aid in the stabilization of glycocalyx, which may result in less bleeding. However, patients often require several “doses,” (or bottles worth) which can be cost prohibitive.
Depending on what type of lyophilized platelet you use, lyophilized platelets need to be reconstituted with sterile water, administered with a needle or catheter greater than 20 gauge in size, followed by a saline flush and should not be administered through a blood filter. Rehydrated platelets typically need to be utilized immediately after reconstitution and typically expire shortly thereafter (e.g., within 1 hour). In a study by Davidow et al published in JVECC in 2012, the use of transfused lyophilized platelets was considered both feasible and associated with a low rate of transfusion reaction in a small number of dogs, and can be considered for severe thrombocytopenia.