Investigation of factors associated with allergic transfusion reaction due to platelet transfusion and the efficacy of platelets resuspended in BRS‐A in adult patients

Abstract

BACKGROUND Although allergic transfusion reactions (ATRs) resulting from platelet concentrate (PC) are a common adverse reaction, the mechanism underlying ATRs has not been fully elucidated. Plasma‐replaced PC suspended in bicarbonate Ringer's solution and anticoagulant citrate dextrose solution A (RPC‐B) is effective for preventing ATRs in children in Japan; however, there is not enough evidence in adult populations. STUDY DESIGN AND METHODS We conducted a retrospective analysis focused on factors associated with ATRs developing from PC transfusions in adult patients in a single institution between 2015 and 2018. The clinical efficacy of RPC‐B for adult patients was also analyzed. RESULTS In total, 4,677 untreated regular PC products in plasma were transfused into 914 patients. ATRs developed in 65 patients (7.1%) treated with 92 PC products (2.0%). Multivariate analysis revealed that patients who were elderly, diagnosed with a non‐hematological disease, and who received a transfusion of fresh‐frozen plasma and red blood cell concentrate products together with PC products had lower frequencies of ATRs. Although 40 patients received 490 RPC‐B transfusions, six ATRs (1.2%) were confirmed in five patients (12.5%). The ATR frequency was not significantly lower in the analysis of all patients; however, ATRs in patients with hematological diseases were lower in terms of both the patient and product numbers. Corrected count increments (24 hr) were also within an acceptable range in patients with hematological diseases. CONCLUSION Several patient‐specific factors may be associated with the development of ATRs from PC transfusion. Because RPC‐B appears to efficiently prevent ATRs, even in adult patients, safe and efficient transfusions may be performed by using RPC‐B preferentially depending on the patient's risk factors.

Retrospective evaluation of fresh platelet concentrate administration in dogs: Patient characteristics, outcomes, and transfusion practices in 189 transfusion episodes (2008–2019)

“…However, these animals were also receiving whole blood transfusions, so adverse reactions to PC specifically cannot be determined 6 . The frequency of transfusion reactions reported in these 2 studies is similar to human studies, where the incidence of adverse events after PC transfusion varies between 2.2% and 13.7% 42–45 . In the present study, transfusions reactions were rare, and their evaluation was complicated by the administration of other blood products before or after PC transfusion.…”

“…6 The frequency of transfusion reactions reported in these 2 studies is similar to human studies, where the incidence of adverse events after PC transfusion varies between 2.2% and 13.7%. [42][43][44][45] In the present study, transfusions reactions were rare, and their evaluation was complicated by the administration of other blood products before or after PC transfusion. However, the prevalence here was lower than previously reported in veterinary medicine.…”

Solvent/detergent treated pooled human plasma can decrease the recurrence of allergic transfusion reactions in pediatric, adolescent, and young adult patients

“…3,4 Also, ATR was more frequent in patients with underlying hematological diseases. 5 The presentation can range from mild urticaria to life-threatening anaphylactic reaction. 1,6 Because the etiology of ATR is multifactorial, many methods have been tried over time to prevent the occurrence of these reactions.…”

Relationship between allergic transfusion reactions and allergic predisposition among pediatric patients with hematological/oncological disease

“…Especially in patients with hematological and oncological disease, ATRs may occur with a particularly high frequency after transfusion of both platelet and red blood cell products 3,7 . Interestingly, ATRs have been shown to occur frequently in patients with hematological diseases, even in adults 9 . Therefore, despite the presence of risk factors specific to children, some risk factors, such as the presence of underlying disease, are common for adults and children.…”

“…3,7 Interestingly, ATRs have been shown to occur frequently in patients with hematological diseases, even in adults. 9 Therefore, despite the presence of risk factors specific to children, some risk factors, such as the presence of underlying disease, are common for adults and children.…”