Bacterial sepsis secondary to platelet transfusion: an adverse effect of extended storage at room temperature

Braine, Hayden G.; Kickler, Thomas S.; Charache, Patricia; Ness, Paul M.; Davis, James M.; Reichart, Cindy A.; Fuller, Alice K.

doi:10.1046/j.1537-2995.1986.26486262752.x

Cited by 134 publications

(65 citation statements)

References 7 publications

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“…On the other hand CNSC is a well-recognized cause of infections in granulocytopenic patients [37, 38]. As infections and septicemia due to transfusion of standard blood products contaminated by CNSC have been described, some authors suggested to discard contaminated hematopoietic autografts [39, 40, 41, 42, 43, 44]. …”

Section: Discussionmentioning

confidence: 99%

Bacterial Contamination of Autologous Bone Marrow: Reinfusion of& ;Culture-Positive Grafts Does Not Result in Clinical Sequelae during the Posttransplantation Course

et al. 1998

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Objectives: Microbiological cultures and posttransplantation course were analyzed in order to investigate the incidence and clinical significance of bacterial contamination of autologous bone marrow (BM) grafts. Methods: Cultures were obtained from BM after collection, BM concentrate after processing, contaminated/cryopreserved BM at thawing, and from peripheral blood (PB) following autologous BM transplantation (ABMT). The posttransplantation course of patients grafted with culture-positive BM was recorded and compared with patients who underwent ABMT with noncontaminated BM grafts. Results: In 239 BM grafts processed, the incidence of microbiological contamination was 26.4% (n = 63). Fifty marrow grafts were contaminated by bacteria from the skin flora: coagulase-negative Staphylococcus (CNSC), Propionibacterium, and Corynebacterium species (79%). Thirty-eight patients underwent ABMT (day 0) with cryopreserved culture-positive BM, and 32 patients were evaluable for microbiological cultures at thawing: in 10 of 32 BM grafts CNSC was found prior to reinfusion. Following ABMT, PB cultures revealed CNSC in 5 of 38 patients between days +4 and +12. However, the late occurrence of positive PB cultures after BM reinfusion made a relationship between BM CNSC and PB CNSC unlikely. In 33 of 38 patients, no graft-contaminating bacteria were detected in PB. Comparison of the posttransplantation course of patients who received contaminated BM with that of patients grafted with noncontaminated BM showed no significant differences concerning time to engraftment, febrile days, and days on antibiotics. Conclusion: (1) Collection and/or ex vivo processing can result in microbiological contamination of BM grafts predominantly with bacteria from the skin flora, and (2) only CNSC can be cultured at thawing from previously contaminated/cryopreserved BM. Since patients undergoing ABMT usually receive oral antibiotics from beginning of the conditioning regimen which are active against CNSC, no further administration of antibiotics is recommended for the reinfusion of bacterially contaminated BM grafts.

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Section: Discussionmentioning

confidence: 99%

Bacterial Contamination of Autologous Bone Marrow: Reinfusion of& ;Culture-Positive Grafts Does Not Result in Clinical Sequelae during the Posttransplantation Course

et al. 1998

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“…This combination of storage container, agitation, preservative solution, temperature, and the use of approximately 50 mL of plasma permits satisfactory preservation of platelets for up to 7 days 23,24 However, several instances of bacterial contamination of PCs stored for this period have been reported 25,26 and the storage time from collection to transfusion is is now limited to 5 days. 27 Because several units of PC are pooled to obtain a dose for one transfusion, one reason to use single-donor apheresis platelets is to minimize the number of donors to which the patient is exposed and, theoretically, to minimize the likelihood of disease transmission.…”

Section: Prophylactic Platelet Transfusionsmentioning

confidence: 99%

Platelet Transfusion Therapy

Karim

Hoque²,

Hoque

et al. 2017

Anwer Khan Mod Med Coll J

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Patients with severe thrombocytopenia are presumed to be at increased risk for bleeding, and consequently it has been standard practice for the past four decades to give allogeneic platelet transfusions to severely thrombocytopenic patients as supportive care. Platelet transfusions may be given either prophylactically to reduce the risk of bleeding, in the absence of clinical hemorrhage (prophylactic transfusions), or to control active bleeding when present (therapeutic transfusions). Platelets for transfusion can be prepared either by separation of units of platelet concentrates (PCs) from whole blood, which are pooled before administration, or by apheresis from single donors. Comparative studies have shown that the post transfusion increments, hemostatic benefit, and side effects are similar with either product. Thus, in routine circumstances, they can be used interchangeably. In most centers, pooled PCs are less costly. Single-donor platelets from selected donors are preferred when histocompatible platelet transfusions are needed. Both preparations can be stored for up to 5 days after collection at 20°C to 24°C with good maintenance of platelet viability. It is now uncommon for patients undergoing intensive chemotherapy or bone marrow transplantation to die of hemorrhage, but it is open to debate as to what degree platelet transfusions have been responsible for this change in outcome, given the many other advances in other aspects of supportive care.Anwer Khan Modern Medical College Journal Vol. 6, No. 2: July 2015, P 40-46

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“…This damage essentially prevents the in vivo 'survival' of platelets [32]. Moreover, storage times have already been reduced from 7 to 5 days based on study results documenting that bacteria can rapidly proliferate under these conditions [33]. While further decreases in storage time may decrease bacterial infections, they will also adversely limit and impact the blood supply [34].…”

Section: Bacterial Infectionsmentioning

confidence: 99%

Economics of Transfusion

Yeh¹,

Botteman²,

Pashos³

et al. 2002

Transfus Med Hemother

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Despite recent advances in blood screening techniques, transfusions are not risk-free procedures. Screening for viral and bacterial infections as well as other newly emerging agents continues to attract attention in the medical and health policy communities. At the same time, as healthcare costs rise and available financial resources are limited, governments and other decisionmaking bodies increasingly require cost-effectiveness analyses to justify (or reject) allocation of those limited resources to new technologies. These cost-effectiveness analyses can demonstrate effectively the benefits and risks of the technologies with respect to their impact on clinical, economic and patient quality-of-life outcomes. This paper reviews the costs of transfusion in several countries and discusses the cost-effectiveness of various transfusion-relevant blood safety interventions as well as other preventative measures. Blood safety measures tend to have high cost-effectiveness ratios, suggesting that the cost per life year saved is high. However, given the extraordinarily high value that society places on measures to reduce unintentional deaths and injuries, particularly those related to blood safety, and the importance of this issue in policy decision-making, such high ratios may be acceptable.

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Bacterial sepsis secondary to platelet transfusion: an adverse effect of extended storage at room temperature

Cited by 134 publications

References 7 publications

Bacterial Contamination of Autologous Bone Marrow: Reinfusion of& ;Culture-Positive Grafts Does Not Result in Clinical Sequelae during the Posttransplantation Course

Bacterial Contamination of Autologous Bone Marrow: Reinfusion of& ;Culture-Positive Grafts Does Not Result in Clinical Sequelae during the Posttransplantation Course

Platelet Transfusion Therapy

Economics of Transfusion

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