Platelet transfusion practice and related transfusion reactions in a large teaching hospital

Liker, M.; Bojanić, Ines; Plenković, Fini; Lukić, Marija; Tomac, Gordana; Raos, Mirela; Ćepulić, Branka Golubić

doi:10.1016/j.tracli.2021.08.004

Cited by 9 publications

(4 citation statements)

References 47 publications

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“…The risk of hemolytic transfusion reactions associated with platelet transfusions was assessed to be low. These findings have been confirmed in smaller, more recent cohorts of children [32,33].…”

Section: Risks Associated With Platelet Transfusionssupporting

confidence: 55%

Pediatric platelet transfusions in critical illness: a narrative review of recent studies

Atchison

Mahmood

Nellis

2022

Current Opinion in Pediatrics

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Purpose of review We sought to describe the current use of platelet transfusions, harms associated with platelet transfusion, new methods of platelet processing that attempt to address these harms, and recent platelet transfusion guidance specific to critically ill children. Recent findings Platelet transfusions have been associated with significant morbidity and mortality. New processing techniques, such as pathogen reduction, have been developed to combat infectious risks but in a recent trial of platelet transfusion thresholds in neonates, transfusing platelets more liberally was associated with increased bleeding and mortality. Summary Recent efforts to develop evidence-based guidelines for platelet transfusion in critically ill children were limited by the lack of evidence. However, given the significant risks, restrictive transfusion thresholds should be considered.

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Section: Risks Associated With Platelet Transfusionssupporting

confidence: 55%

Pediatric platelet transfusions in critical illness: a narrative review of recent studies

Atchison

Mahmood

Nellis

2022

Current Opinion in Pediatrics

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“…Of these, 77 were included. Through handsearching, we also found three additional reports and/or articles that were eligible for inclusion, 22–24 making a total of 80 studies for the final meta‐analysis 25–96 . The UK's Serious Hazards of Transfusion (SHOT) issues annual reports of transfusion‐related adverse events, and we were able to include data from 2003 to 2022, with the exception of 2009 in which the Supplementary Tables were not available for that year.…”

Section: Resultsmentioning

confidence: 99%

The incidence of transfusion‐related acute lung injury using active surveillance: A systematic review and meta‐analysis

White,

Walker,

Schmidt

et al. 2023

Transfusion

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BackgroundTransfusion‐related acute lung injury (TRALI) is a leading cause of transfusion‐related mortality. A concern with passive surveillance to detect transfusion reactions is underreporting. Our aim was to obtain evidence‐based estimates of TRALI incidence using meta‐analysis of active surveillance studies and to compare these estimates with passive surveillance.Study Design and MethodsWe performed a systematic review and meta‐analysis of studies reporting TRALI rates. A search of Medline and Embase by a research librarian identified studies published between January 1, 1991 and January 20, 2023. Prospective and retrospective observational studies reporting TRALI by blood component (red blood cells [RBCs], platelets, or plasma) were identified and all inpatient and outpatient settings were eligible. Adult and pediatric, as well as general and specific clinical populations, were included. Platelets and plasma must have used at least one modern TRALI donor risk mitigation strategy. A random effects model estimated TRALI incidence by blood component for active and passive surveillance studies and heterogeneity was examined using meta‐regression.ResultsEighty studies were included with approximately 176‐million blood components transfused. RBCs had the highest number of studies (n = 66) included, followed by platelets (n = 35) and plasma (n = 34). Pooled TRALI estimates for active surveillance studies were 0.17/10,000 (95% confidence intervals [CI]: 0.03–0.43; I2 = 79%) for RBCs, 0.31/10,000 (95% CI: 0.22–0.42; I2 = <1%) for platelets, and 3.19/10,000 (95% CI: 0.09–10.66; I2 = 86%) for plasma. Studies using passive surveillance ranged from 0.02 to 0.10/10,000 among the various blood components.DiscussionIn summary, these estimates may improve a quantitative understanding of TRALI risk, which is important for clinical decision‐making weighing the risks and benefits of transfusion.

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“…During our studies, our blood center changed to prepare pooled PCs from 5 BCs in plasma to PAS‐E, aiming for less activation of PLTs during storage 7 and decrease of transfusion reactions, 8 so the next studies were performed with PLTs in PAS‐E. After selection of BCs from both male and female donors >45 years, sPCs were prepared, but BCs were diluted with 60 ml PAS‐E (T‐PAS+, TerumoBCT, Lakewood, CA) instead of plasma and the centrifugation spin of the cell suspension was more gentle due to lower viscosity (153 × g , 5 min).…”

Section: Methodsmentioning

confidence: 99%

Donor variation in stored platelets: Higher metabolic rates of platelets are associated with mean platelet volume, activation and donor health

et al. 2022

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Background Platelets (PLTs) differ in glycolytic activity, resulting in rapid acidification of ‘poor’ storing PLT concentrates (PCs) in plasma, or depletion of glucose when stored in PLT additive solution (PAS). We aimed to understand why PLT glycolysis rates vary between donors and how this affects storage performance. Study Design and Methods Buffy coats from donors <45, 45–70 and >70 years were selected and single‐donor PCs in plasma or PAS‐E were prepared. PCs were stored for 8 days at 22 ± 2°C and sampled regularly for analysis. Mitochondrial activity was analyzed with an Oroboros oxygraph. Age groups, or subgroups divided into quartiles based on glucose consumption, were analyzed with ANOVA. Results In each comparison, PCs of the different groups were not different in volume and cellular composition. PLTs with the highest glucose consumption had a higher initial mean platelet volume (MPV) and developed higher CD62P expression and Annexin A5 binding during storage. Higher glycolytic activity in these PLTs was not a compensation for lower mitochondrial ATP production, because mitochondrial ATP‐linked respiration of fresh PLTs correlated positively with MPV (R2 = 0.71). Donors of high glucose‐consuming PLTs had more health‐related issues. Storage properties of PCs from donors over 70 were not significantly different compared to PCs from donors younger than 45 years. Conclusions High glucose‐consuming PCs developing higher activation levels, not only displayed enhanced mitochondrial activity but were also found to contain larger PLTs, as determined by MPV. Storage performance of PLTs was found to be associated with donor health, but not with donor age.

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Platelet transfusion practice and related transfusion reactions in a large teaching hospital

Cited by 9 publications

References 47 publications

Pediatric platelet transfusions in critical illness: a narrative review of recent studies

Pediatric platelet transfusions in critical illness: a narrative review of recent studies

The incidence of transfusion‐related acute lung injury using active surveillance: A systematic review and meta‐analysis

Donor variation in stored platelets: Higher metabolic rates of platelets are associated with mean platelet volume, activation and donor health

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