Advances in the preparation and clinical application of freeze-dried platelets

Freeze-dried platelets (FDPs), characterized by long-term storage at the ambient temperature, convenient transport and pathogen inactivation, are extensively studied in transfusion and regenerative medicine. This review summarizes the whole preparation procedures of FDPs including pretreatment, pre-freezing, lyophilization and rehydration, compares four rehydration media, and reviews FDP applications in thrombocytopenia transfusion, traumatic shock rescue and tissue repair. FDPs exhibit favorable hemostatic activity and biocompatibility, but they are vulnerable to lyophilization-induced structural damage, weak in vitro aggregation function, inadequate in clinical trials and unified quality control standards. Future research will focus on developing compound protectants, standardizing preparation workflows, clarifying molecular mechanisms of lyophilization injury via multi-omics, and establishing unified quality specifications through multicenter clinical trials. Optimized preparation technologies of FDPs will revolutionize the way platelets are stored and transported so as to provide a novel blood product for emergency hemostasis and wound repair.