Autologous Cold-stored Apheresis Platelets

Inclusion criteria

Adult (≥18 years old) patients who meet all following criteria:

• 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