Released washed platelet concentrates are effective and safe in patients with a history of transfusion reactions

Fujiwara, Shin-ichiro; Fujishima, Naohito; Kanamori, Heiwa; Ito, Masumi; Sugimoto, Tatsuya; Saito, Shoko; Sakaguchi, Takeshi; Nagai, K; Masuoka, Hidekazu; Nagai, Kazuhiro; Morita, Akie; Kino, Shuichi; Tanaka, Asashi; Hasegawa, Yoshinori; Yokohama, Akihiko; Fujino, Keizo; Makino, Shigeyoshi; Matsumoto, Mayumi; Takeshita, Akira; Muroi, Kazuo

doi:10.1016/j.transci.2018.09.001

Cited by 11 publications

(8 citation statements)

References 23 publications

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“…Recently, a mixture of bicarbonate Ringer's solution and anticoagulant citrate dextrose solution A (BRS-A) was reported to be a relatively easily prepared PAS with potential to maintain platelet qualities for a longer period. 16,17 Although the Japanese Red Cross Blood Center started to provide automatically adjusted washed PC with BRS-A, 18,19 a limited quantity of this kind of washed PC is available each day. Furthermore, prior planning is necessary for the use of washed PC with BRS-A.…”

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confidence: 99%

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

et al. 2019

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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.

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confidence: 99%

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

et al. 2019

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“…20 The Japanese Red Cross Society obtained manufacturing and marketing approval for washed PLT products from the Ministry of Health, Labor and Welfare in Japan in March 2016 and began distribution in September 2016. 21 Several immunomodulatory factors that can accumulate in the storage media, such as soluble CD40 ligand (sCD40L) and platelet-derived microparticles (PDMPs), may lead to platelet transfusion reactions. [22][23][24] Iwama et al 25 compared the in vitro properties of PLTs washed with M-sol and BRS-A, and concluded that these in vitro properties were not markedly different.…”

Section: Resultsmentioning

confidence: 99%

“…Recently, Kobayashi et al reported that washed PLTs with BRS‐A using the manual method appear to prevent allergic transfusion reactions without loss of transfusion efficacy in children with primary hematologic and malignant diseases. Fujiwara et al demonstrated that washed PLTs released by the Japanese Red Cross Society were effective and safe in patients with a history of transfusion reactions. Further prospective studies are needed to clarify the clinical effectiveness of washed PLTs in BRS‐A prepared with ACP215.…”

Section: Discussionmentioning

confidence: 99%

“…Once the procedure is started, BRS‐A additive solution is prepared by automatically mixing BRS and ACD‐A in a ratio of 20:1, and washed PLTs can be obtained in the product bag without residual PLTs in a separation bowl . The Japanese Red Cross Society obtained manufacturing and marketing approval for washed PLT products from the Ministry of Health, Labor and Welfare in Japan in March 2016 and began distribution in September 2016 …”

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Impact of the platelet washing process on in vitro platelet properties, and the levels of soluble CD40 ligand and platelet‐derived microparticles in the storage media

Oikawa

Minegishi²,

Endo

et al. 2018

Transfusion

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BACKGROUND A new platelet (PLT) additive solution, bicarbonated Ringer's solution supplemented with acid‐citrate‐dextrose Formula A, termed BRS‐A, as well as a new automated closed system cell processor for washing PLTs have recently been developed. This study evaluated the in vitro properties of PLTs with the automated system versus the manual method, using the BRS‐A additive solution for washing and storage. METHODS ABO‐identical apheresis PLTs in 100% plasma were pooled and split equally for control (in 100% plasma or a manual method) and test (ACP215 automated system) units. In vitro characteristics of PLTs washed with the automated system were compared to those of PLTs in 100% plasma (Study 1) or washed with a manual method (Study 2) during the 7‐day storage. RESULTS In Study 1, hypotonic shock response, aggregation response, mitochondrial membrane potential, adenosine triphosphate, and CD42b mean fluorescence intensity were comparable in the control and test groups during the 7‐day storage. CD62P expression was lower in the test group than controls on Days 3 and 7. The level of platelet‐derived microparticles (PDMPs) in the test group on Days 1 and 2 were higher than those in controls. In contrast, the levels of soluble CD40 ligand (sCD40L) and regulated upon activation of normal T‐cell expressed and secreted (RANTES) in the test units were lower than controls. In Study 2, no significant differences were found in all in vitro properties except for PLT count and the levels of PDMPs in the test units were higher than controls during storage. CONCLUSION Apheresis PLTs washed with the automated system using BRS‐A additive solution maintained in vitro properties during storage. Washing methods influenced PDMP levels but not sCD40L and RANTES.

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“…113,[118][119][120] As a result, starting in September 2016, high-quality washed PCs with 98% or more of plasma from the Japanese Red Cross Blood Society have been supplied to all medical institutions in Japan. 57,121,122 Besides the prevention of TARs, washed PCs are also used when it is difficult to supply ABO-compatible blood products, such as HLA-compatible PCs, and when transfusing ABO-incompatible PCs is unavoidable. In particular, washed PC transfusion is considered when anti-A or B antibody titers of blood products are high or for young children with low circulating blood volumes.…”

Section: Washed Pcs In Japan In the Futurementioning

confidence: 99%

Preventing adverse reactions in pediatric transfusions using washed platelet concentrate

Yanagisawa

2021

Pediatrics International

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Blood transfusion is an important form of supportive care in children; however, transfusion-associated adverse reactions (TARs) are a problem. As with adults, allergic transfusion reactions (ATRs) and febrile non-hemolytic transfusion reactions (FNHTRs) are major TARs, and the frequency of ATRs caused by platelet concentrate (PC) tends to be particularly high. The plasma component of the blood product is thought to be a major factor in the onset of TARs such as ATR and FNHTR. By contrast, in children, age, underlying disease, and number of blood transfusions may be relevant patient-related factors. Although acetaminophen or diphenhydramine may be used prophylactically to prevent TARs, there is no clear evidence of their effectiveness. Volume-reduced PC is used to prevent TARs; however, it may be difficult to maintain the quality of platelets. Plasma-replaced PC stored with platelet additive solution raises the concern that TARs cannot be completely prevented by residual plasma. Washed PC removes most of the plasma, so it can effectively prevent ATR and FNHTR. The recent development of platelet additive solution [M-sol, bicarbonate Ringer's solution supplemented with acid-citrate-dextrose formula A (BRS-A)] in Japan has enabled the maintenance of the quality of platelets for long periods. The clinical use of washed PC in Japan has therefore progressed. Washed PC with M-sol or BRS-A for pediatric patients can effectively prevent TARs without diminishing the transfusion effect. The supply of washed PC has begun from the Japanese Red Cross Society, and it has become possible to use washed PC at all medical institutions in Japan.

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Released washed platelet concentrates are effective and safe in patients with a history of transfusion reactions

Cited by 11 publications

References 23 publications

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

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

Impact of the platelet washing process on in vitro platelet properties, and the levels of soluble CD40 ligand and platelet‐derived microparticles in the storage media

Preventing adverse reactions in pediatric transfusions using washed platelet concentrate

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