Refrigeration effects on platelet integrity: physical, biochemical, and functional insights

Cold storage at 2–6°C has re-emerged as a potential strategy to improve platelet preservation; however, its effects on platelet activation, metabolic stability, and functional integrity remain incompletely defined. This prospective experimental study aimed to investigate the impact of cold versus room-temperature storage on apheresis platelet integrity, with particular emphasis on thromboxane B2 (TXB2) as a mechanistic marker linking storage conditions to platelet activation and functional performance. Platelet concentrates from ten healthy donors were assigned into three groups: RT with agitation (GI), cold with agitation (GII), and cold without agitation (GIII). Samples were evaluated on Days 1, 3, and 5 for platelet count, TXB2 concentration using ELISA, and biochemical parameters, including pH, electrolytes, glucose, and blood gases. RT-stored platelets showed a significant increase in TXB2 levels by Day 5. In contrast, cold storage limited TXB2 accumulation and better preserved metabolic stability, particularly pH and glucose levels. The comparative evaluation of agitated and non-agitated cold storage further suggested that refrigeration was the dominant protective factor, while agitation exerted a limited but potentially supportive effect on functional stability. In Conclusion, this study provides an integrated mechanistic assessment of refrigerated platelet storage by linking physical changes, biochemical preservation, and TXB2-mediated functional activity.