Conventional platelets last five to seven days. Cryopreserved platelets last two years. So why aren't we using them everywhere?
In this episode of the eCritCare Podcast, Dr Swapnil Pawar sits down with Professor Michael Reade, intensivist, researcher and chief investigator of the CLIP-II trial, published in JAMA in 2026. CLIP-II randomised 388 high-risk cardiac surgical patients across 11 Australian hospitals and compared cryopreserved platelets with standard liquid-stored platelets in the 202 who needed a transfusion.
The headline result: cryopreserved platelets did not meet the pre-specified 20% non-inferiority margin for chest drain bleeding in the first 24 hours. But as Professor Reade explains, that is only part of the story.
In this conversation:
Why cardiac surgery was the right population, and the platelet transfusion risk calculator that came out of it
How the team achieved double blinding with blood products (and what may have unblinded clinicians anyway)
Why 20% was chosen as the non-inferiority margin
What "could not conclude non-inferiority" actually means, and why 13% of not very much is not very much
The mortality signal and what it does and does not tell us
Would he give frozen platelets to a bleeding patient in a regional hospital? Yes.
The unpublished New Zealand and US military trials still to come
Behind the scenes: training blood bank staff, minus 80 freezers, and running a trial through COVID
Paper: Reade MC, Marks DC, Howe BD, et al. Cryopreserved vs Liquid-Stored Platelets for the Treatment of Surgical Bleeding: The CLIP-II Randomized Noninferiority Clinical Trial. JAMA. 2026;335(7):600-608. doi:10.1001/jama.2025.23355
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