Febrile and allergic transfusion reactions after the transfusion of white cell‐poor platelet preparations

Background: The Mirasol pathogen reduction technology (PRT) system uses riboflavin and ultraviolet light and is currently approved and used in Europe for the treatment of platelets and plasma. Mirasol treatment is intended to reduce the infectious pathogen load and to inactivate leukocytes in blood products. Our objective was to evaluate buffy coat platelet concentrates (BCPCs) prepared with platelet additive solution (PAS) and treated with the Mirasol system and to examine the effects on platelet cell quality during storage. Methods: 26 BCPCs were prepared and split, creating 13 paired control and test units. The test units were treated with the Mirasol system and the platelet quality was assessed in all units over 7 days of storage. Results: All products met the incoming specifications for Mirasol treatment, and the pH of all Mirasol-treated BCPCs in PAS met the requirements of the Council of Europe guidelines throughout storage. Analysis of lactate production and glucose consumption rates, CD62p expression and cytokines indicates enhanced cellular metabolism in treated platelets, but the levels were within previously published ranges. Conclusion: While Mirasol-treated BCPCs in PAS had increased metabolism and activation compared to controls, the results indicate that these units can be stored for 7 days with acceptable cell quality.

Section: Discussionmentioning

confidence: 78%

Treatment of Buffy Coat Platelets in Platelet Additive Solution with the Mirasol<sup>®</sup> Pathogen Reduction Technology System

Castrillo

Cardoso²,

Rouse³

2013

“…They found 6.4% and 7.7% inflammatory reactions in patients receiving whole blood-derived PCs and SDAP, respectively; allergic reactions were observed in 4.1% and 4.8% of the patients receiving whole blood-derived PCs and SDAP, respectively. In our previous study [7], the overall adverse reaction rate after transfusion of 2,947 prestorage WBC-depleted PCs (770 SDAPs and 2,177 BC-PCs) was 1.56%. The frequencies of FNHTR according to the literature for different PC preparations and WBC contaminations are given in figure 1.…”

Section: Incidence Of Nonhemolytic Transfusion Reactionsmentioning

confidence: 83%

“…Particularly the implementation of leukocyte depletion technologies has led to a marked decrease of febrile reactions. Recent studies suggest that NHTR occur in about 1.5-7% of PC transfusions [6,7]. Further improvements in PC preparations, e.g.…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, RANTES can induce the histamine release of basophils [30]. It seems to play a role in allergic reactions as RANTES concentrations were significantly higher in PCs involved in allergic transfusion reactions in comparison to controls [7]. RANTES release from platelets can be induced by alloantibodies to human platelet antigens [31], indicating that these alloantibodies might be the causative agent for a part of NHTR after PC transfusion.…”

Section: Incidence Of Nonhemolytic Transfusion Reactionsmentioning

confidence: 99%

See 1 more Smart Citation

Febrile and Allergic Reactions after Transfusion of Platelet Concentrates

Hartwig¹,

Klüter²

2003

Self Cite

Febrile and allergic transfusion reactions are well-known side effects after transfusion of platelet concentrates. Febrile reactions are regularly accompanied by chills and rigor. Allergic reactions are mostly mild with local, sporadically general urticaria, but they can lead to a severe, life-threatening anaphylactic shock syndrome. The causative agent of allergic reactions cannot be characterized precisely in most of the cases. White cell-reactive alloantibodies of the recipient as well as accumulation of proinflammatory cytokines such as interleukin-1, interleukin- 6 or tumor necrosis factor-alpha in the supernatant of platelet concentrates, mainly released during storage by contaminating leukocytes, play a causative role in febrile reactions. However, even after transfusion of leukocyte-reduced platelet concentrates, febrile transfusion reactions are less frequent, but still occur. This indicates that other mediators, either in the plasma or released by the platelets themselves, may also be inductors for these reactions. This review reports about clinical manifestations, treatment, and pathophysiology of nonhemolytic transfusion reactions and gives an overview of precautions that may be undertaken to prevent such reactions.

“…After a longer storage interval there was no difference in CCI between the two groups. Klüter et al [6] studied both bedside and inline filtration in terms of nonhemolytic transfusion reactions (NHTR). There was no difference in the incidence of NHTR between both groups of patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Prefiltration and Bedside Filtration in Thrombocytopenic Children with Malignant Diseases

Reinhard¹,

Seyfert²,

Krenn³

et al. 2001

Background: High-dose chemotherapy according to recent protocols causes a high rate of bone marrow aplasia. Platelet transfusions in immunocompromised patients need a consequent leukocyte depletion to prevent infections, alloimmunization and immunomodulation. Leukocyte depletion can either be done as inline filtration or as bedside filtration. To prevent graft-versus-host disease platelet concentrates are generally irradiated before transfusion. Methods: From June 1999 to May 2000 we administered 235 platelet concentrates in 38 pediatric patients with malignancies. The number of transfusions per patient varied from 1 to 28. In all patients the absolute platelet count was determined before and after transfusion. 118 concentrates were bedside-filtered, in 117 concentrates inline filtration was done. All concentrates were irradiated with 30 Gy before transfusion. In 116 platelet concentrates we detected the concentration before transfusion and calculated the corrected count increment (CCI). Half of these concentrates was bedside-filtered, the other half was inline-filtered. Results: The mean platelet count of the patients before transfusion was 13,500/µl and that after transfusion 52,000/µl. In the group treated with bedside-filtered concentrates the platelet count increased to 36,000/µl, and in the group treated with inline-filtered concentrates it rose to 68,000/µl. The difference is statistically significant (p < 0.0001). By detecting the platelet count in the concentrate directly after production and again after bedside filtration, a significant platelet loss could be shown. Conclusion: Inline-filtered platelet concentrates should be preferred for the transfusion in thrombocytopenic patients.