An evaluation of the clinical impacts of 7‐day platelets

Abstract

Background: In August 2017, Canadian Blood Services extended the shelf-life of platelet concentrates from 5 to 7 days. The clinical impacts of this policy change remain unclear.Study Design and Methods: We used a before-after retrospective design of platelet-transfused adult inpatients in Hamilton, ON, Canada. Data were captured for 18 months before (Period 1: February 2016-July 2017) and 18 months after (Period 2: September 2017-February 2019) 7-day platelet implementation.Primary outcome was absolute platelet count increment (ACI) in univariate and multivariate analyses adjusted for confounders. Data were obtained from our institution's transfusion database, Ontario's Transfusion Transmitted Injuries Surveillance System, and the blood supplier. Results: Overall, 1360 patients with single dose platelet transfusions were included in Period 1 and 1211 patients in Period 2. Median age at admission was 66 years, and approximately 40% of patients underwent cardiac surgery. Using a non-inferiority margin of À10 Â 10 9 /L, platelets transfused during the 7-day storage period were non-inferior to those transfused in the 5-day storage period [mean count difference À 4.63 Â 10 9 /L (95% CI À7.40 to À1.87, p = 0.0001)].However, platelet ACIs following transfusion consistently trended lower in the 7-day group for all patients and subgroups. No differences in secondary clinical outcomes were observed. Platelet expiry reduced from 8.1 to 6.3% (p < 0.0001). Conclusion:Platelet transfusions following 7-day storage policy were noninferior to transfusions in the 5-day policy period, although reduced ACIs were observed. There were no increases in adverse clinical outcomes.Platelets are a valuable, life-saving blood product transfused to prevent or treat bleeding. The duration of storage of platelets varies across countries. Some countries employ a short storage time, with a platelet shelf life of

Platelet transfusions in adult thrombocytopenic ICU patients: Protocol for a sub‐study of the PLOT‐ICU cohort

“…[9][10][11] Previous studies reporting data on the use of platelet transfusions in adult ICU patients have primarily focused on indications for platelet transfusions, pre-transfusion platelet counts and post-transfusion platelet count increments. 3,8,[12][13][14][15][16][17][18] Some studies have reported data from general ICU patients, 8,[12][13][14]17 but few have been international. 13 Data describing other important aspects of the epidemiology of platelet transfusions, such as the type of platelet product used (apheresisderived versus pooled whole-blood-derived), platelet transfusion volumes, method of dosing and the timing of transfusion during ICU stay, are scarce.…”

“…Previous studies reporting data on the use of platelet transfusions in adult ICU patients have primarily focused on indications for platelet transfusions, pre‐transfusion platelet counts and post‐transfusion platelet count increments 3,8,12–18 . Some studies have reported data from general ICU patients, 8,12–14,17 but few have been international 13 .…”