Autologous Cold-stored Apheresis Platelets
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Autologous Cold-Stored Platelets, Allogeneic Room Temperature-Stored Platelets (Standard of Care).
- Who it may be relevant to
- Registry conditions: Bleeding, Platelets, Cardiopulmonary Bypass, Cardiac Surgery. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Canada
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Auto-PLTS: The Effectiveness of Autologous, Cold-stored Platelets Collected 7-10 Days Before Cardiac Surgery for Avoidance of Allogeneic Transfusions: A Randomized Patient Preference Trial
Overview
The Auto-PLTS Study is a single-centre trial performed at Toronto General Hospital (TGH) that uses a randomized, patient preference design. The recent introduction of cold-stored platelets with a shelf-life of 14 days into clinical practice has made it possible to offer autologous apheresis platelet predonation to patients undergoing elective cardiac (and other high-blood-loss) surgeries while allowing sufficient time to recover platelet count before surgery. The Auto-PLTS Study is designed to assess whether replacing allogeneic platelets with autologous platelets will improve patient outcomes and benefit the healthcare system by reducing the burden on allogeneic platelet supply. The study is also designed to determine whether patients are willing to donate autologous platelets 7-10 days prior to surgery.
Interventions
- Biological Autologous Cold-Stored Platelets
Two units of autologous platelets will be collected via an apheresis machine that draws blood from an intravenous (IV) line over 1-2 hours, isolates and leukoreduces the platelets by centrifugation and returns the remaining blood back to the patients. Collected autologous platelets will be stored at 1-6℃ without agitation until they are needed during or after surgery or 14 days have elapsed since their collection, after which they will be destroyed as per standard institutional procedures for ex - Biological Allogeneic Room Temperature-Stored Platelets (Standard of Care)
Allogeneic platelets will be collected by Canadian Blood Services as per their standard operating procedures. Room temperature stored platelets will be stored at 20-24°C with constant agitation for up to 7 days as per current practices. For any platelet orders within 24 hours of cardiopulmonary bypass (CPB) termination, patients in the control group will receive allogeneic platelets as per usual care.
Primary outcome measures
- Primary Efficacy Endpoint [Time frame: up to 24 hours after termination of cardiopulmonary bypass (CPB)]
Eligibility criteria
Inclusion criteria
Adult (≥18 years old) patients who meet all following criteria:
1\. Undergoing elective complex cardiac surgery consisting of at least one of the following:
- Repair or replacement of more than one valve (i.e., multiple valves)
- Repair or replacement of any segment of aortic arch
- At least two of any combination of coronary artery bypass grafting (CABG), valve repair/replacement, or aorta (ascending/arch) repair/replacement
- Complex adult congenital repair
Exclusion criteria
Patients who meet any of the following criteria are not eligible for the study:
- Seven days or less from recruitment to surgery (as there will not be sufficient time from platelet donation to surgery for patients to recover their platelet count)
- Patient factors that preclude platelet donation or increase risk of adverse events after donation, including any of the following:
- Poor intravenous access
- Low baseline platelet count (≤150,000 x106/L)
- Low baseline hemoglobin (<100 g/L) (since approximately 50 mL of red blood cells are lost with each unit of apheresis platelet collection)
- Inability to tolerate fluid shifts during donation (i.e., severe aortic stenosis with valve area <0.7 cm2, or left main coronary artery stenosis >80%, or left ventricular ejection fraction <30%)
- Increased risk of bacterial contamination of collected units (i.e., active infection, on antibiotics, dental procedure <72 hours before donation)
- Attending clinicians deem the patient ineligible for autologous predonation
- Known positivity for active infectious blood-borne disease (HIV, HCV, HBV, HTLV, Syphilis)
- Highly specialized procedures such as insertion or removal of ventricular assist devices or repair of thoracoabdominal aneurysm
- Any history of congenital or acquired bleeding disorder (including any type of thrombocytopenia or platelet refractoriness due to anti-platelet and anti-HLA antibodies or requirement for specially matched platelets)
- On any anticoagulant or antiplatelet medications, excluding ASA, that cannot be stopped at least 7 days before donation (72 hours for NSAIDs)
- Refusal of allogeneic blood products due to religious or other reasons
- Known or suspected pregnancy
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Canada · 1 center
- Toronto General Hospital - University Health Network — Toronto
Identifiers
NCT: NCT07064954 · 24-5285