Prolonged platelet storage associated with increased frequency of transfusion‐related adverse events

Losos, Michael; Biller, Elizabeth; Li, J.; Blower, Luke; Hamad, Diane; Patel, Gaurang; Scrape, Scott; Cataland, Spero R.; Chen, Jian

doi:10.1111/vox.12622

Cited by 15 publications

(15 citation statements)

References 28 publications

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“…Another recent study showed that prolonged storage of plasma platelets was associated with more inflammatory transfusion reactions (including FNHTRs, TRALI, transfusion‐associated dyspnea, and atypical reactions), but not with allergic reactions . Regarding allergic reactions, this other study is in agreement with our study.…”

Section: Discussionsupporting

confidence: 75%

“…Whether these changes also have clinical consequences is not clear yet, as published results are contradictory . A recently published review paper concludes that the risk of transfusion reactions was similar in old, compared to fresh, leukoreduced units, whereas a more recent study, not included in the review, showed that prolonged storage of platelets was associated with a higher frequency of inflammatory transfusion reactions but not allergic reactions …”

mentioning

confidence: 99%

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Effect of storage of platelet concentrates in PAS‐B, PAS‐C, or plasma on transfusion reactions

et al. 2019

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BACKGROUND: Reports on the clinical consequences of longer storage time of platelet concentrates are contradictory. The objective of this study was to assess whether longer storage times are associated with a higher risk of transfusion reactions. STUDY DESIGN AND METHODS:We gathered storage times of pooled platelet concentrates related to transfusion reactions reported to the national hemovigilance office from 2004 to 2015. These were combined with storage times of platelet concentrates in the reference population to compare incidences of transfusion-associated circulatory overload, transfusionrelated acute lung injury, allergic reactions, febrile nonhemolytic reactions, and "other" reactions between storage time categories. ABBREVIATIONS: FNHTRs = febrile nonhemolytic transfusion reactions; PAS = platelet additive solution; TRALI = transfusionrelated acute lung injury; TRIP = Transfusion and Transplantation Reactions in Patients.From the

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Section: Discussionsupporting

confidence: 75%

mentioning

confidence: 99%

Effect of storage of platelet concentrates in PAS‐B, PAS‐C, or plasma on transfusion reactions

et al. 2019

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“…6 PLTs of older storage age have been independently associated with adverse outcomes in certain adult cohorts including poorer response to PLT transfusions, 7 increased transfusion reactions, 8 and adverse inflammatory events. 9 Critically ill children are at particular risk of requiring PLT transfusions because of underlying organ dysfunction, including suppression of marrow and/or hepatic insufficiency, administration of medications that may suppress functional ability to clot, PLT consumption due to bleeding or microangiopathy, and frequent invasive procedures. PLT transfusions have been independently associated with increased mortality in this patient population.…”

Section: Discussionmentioning

confidence: 99%

“…PELOD-2 score of 7 (4)(5)(6)(7)(8)(9). However, they did not have significant worsening of their organ dysfunction 24 hours after the transfusion, as represented by a median (IQR) change in PELOD-2 score of 0 (−2 to 1).…”

Section: Unadjusted Clinical Outcomesmentioning

confidence: 92%

Effect of platelet storage duration on clinical outcomes and incremental platelet change in critically ill children

et al. 2020

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Background The safety of platelet (PLT) concentrates with longer storage duration has been questioned due to biochemical and functional changes that occur during blood collection and storage. Some studies have suggested that transfusion efficacy is decreased and immune system dysfunction is worsened with increased storage age. We sought to describe the effect of PLT storage age on laboratory and clinical outcomes in critically ill children receiving PLT transfusions. Study Design and Methods: We performed a secondary analysis of a prospective, observational point-prevalence study. Children (3 days to 16 years of age) from 82 pediatric intensive care units in 16 countries were enrolled if they received a PLT transfusion during one of the predefined screening weeks. Outcomes (including PLT count increments, organ dysfunction, and transfusion reactions) were evaluated by PLT storage age. Results: Data from 497 patients were analyzed. The age of the PLT transfusions ranged from 1 to 7 days but the majority were 4 (24%) or 5 (36%) days of age. Nearly two-thirds of PLT concentrates were transfused to prevent bleeding. The indication for transfusion did not differ between storage age groups Abbreviations: IQR, interquartile range; PICU, pediatric intensive care unit. †The P 3 T investigators are listed in the acknowledgements.

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“…Multiple metabolic and signalling reactions that occur during the preparation and storage of platelet concentrates result in platelet activation and leads to accumulation of CD62P [78■■], sCD40L [79] and platelet microparticles (PMPs) [80■], and activation of coagulation factors and generation of mediators of inflammation and immunity, which interact with vascular endothelial cells and neutrophils [81–83] (reviewed in [84■]). Transfusion of platelet concentrates containing activated platelets and mediators of inflammation and cellular injury has been linked to platelet transfusion-associated adverse events.…”

Section: Clinical Consequences Derived Of Storage Dependent Platelet mentioning

confidence: 99%

Towards increasing shelf life and haemostatic potency of stored platelet concentrates

Hegde

Akbar

Zheng

et al. 2018

Current Opinion in Hematology

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Purpose of review Platelet transfusion is a widely used therapy in treating or preventing bleeding and haemorrhage in patients with thrombocytopenia or trauma. Compared with the relative ease of platelet transfusion, current practice for the storage of platelets is inefficient, costly and relatively unsafe, with platelets stored at room temperature (RT) for upto 5–7 days. Recent findings During storage, especially at cold temperatures, platelets undergo progressive and deleterious changes, collectively termed the ‘platelet storage lesion’, which decrease their haemostatic function and posttransfusion survival. Recent progress in understanding platelet activation and host clearance mechanisms is leading to the consideration of both old and novel storage conditions that use refrigeration and/or cryopreservation to overcome various storage lesions and significantly extend platelet shelf-life with a reduced risk of pathogen contamination. Summary A review of the advantages and disadvantages of alternative methods for platelet storage is presented from both a clinical and biological perspective. It is anticipated that future platelet preservation involving cold, frozen and/or pathogen reduction strategies in a proper platelet additive solution will enable longer term and safer platelet storage.

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Prolonged platelet storage associated with increased frequency of transfusion‐related adverse events

Abstract: Prolonged storage of apheresis/irradiated PLTs was associated with a higher frequency of inflammation AEs. Apheresis/irradiated PLTs caused more AEs than WBD/nonirradiated PLTs.

Cited by 15 publications

References 28 publications

Effect of storage of platelet concentrates in PAS‐B, PAS‐C, or plasma on transfusion reactions

Effect of storage of platelet concentrates in PAS‐B, PAS‐C, or plasma on transfusion reactions

Effect of platelet storage duration on clinical outcomes and incremental platelet change in critically ill children

Towards increasing shelf life and haemostatic potency of stored platelet concentrates

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