Single donor versus pooled random donor platelet concentrates

Ness, Paul M.; Campbell‐Lee, Sally

doi:10.1097/00062752-200111000-00013

Cited by 76 publications

(69 citation statements)

References 22 publications

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“…14,15 Some authors advocate the use of SDAP due to less exposure to multiple donors, resulting in smaller risk of contamination with infectious diseases and lower risk of developing alloantibodies. 16,17 However, it is unclear if using SDAP improves outcomes of transfusions, as opposed to using the more readily available pooled platelet concentrates (PPC).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of prophylactic transfusions using single donor apheresis platelets versus pooled platelet concentrates in AML/MDS patients receiving allogeneic hematopoietic stem cell transplantation

Gürkan

Patah

Saliba

et al. 2007

Bone Marrow Transplant

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Superiority of single-donor apheresis platelets (SDAP) over pooled platelet concentrates (PPC) transfusions is largely assumed, but unproven. We hypothesized that prophylactic SDAP and PPC transfusions are clinically equivalent after allogeneic hematopoietic stem cell transplants (HSCT). We studied all transfusions administered to 33 patients with AML/MDS during the first 100 days after busulfan-based, myeloablative HSCT. All donorrecipient pairs were ABO identical. Transfusion threshold was a platelet count p15 Â 10 9 /l. The corrected increment (CCI) was used for all comparisons. Median time to platelet engraftment was 13 days (n ¼ 30). PPC transfusions (n ¼ 105) were ABO compatible, while 10% of 41 SDAP were not (P ¼ 0.006). Median post-transfusion platelet count was 51K/ll (5-118K) after SDAP and 36K/ll (3-115K) after PPC (P ¼ 0.0004). Median CCI was 14.178 (SDAP) versus 7.793 (PPC) (P ¼ 0.0001). Median time to another transfusion was 3 days (SDAP) and 2 days (PPC; P ¼ 0.3). In the week following any given transfusion, the median number of new transfusions was similar (n ¼ 2), as well as the need of further transfusion (16 versus 24%, P ¼ 0.2). A total of 17% of SDAP and 30% of PPC transfusions were labeled 'ineffective' (P ¼ 0.1). There were two non-lethal hemorrhage episodes (6%). SDAP transfusions produced better platelet counts, but SDAP and PPC were equally effective in preventing hemorrhage.

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Section: Introductionmentioning

confidence: 99%

Efficacy of prophylactic transfusions using single donor apheresis platelets versus pooled platelet concentrates in AML/MDS patients receiving allogeneic hematopoietic stem cell transplantation

Gürkan

Patah

Saliba

et al. 2007

Bone Marrow Transplant

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“…PCs that have been gently prepared and then immediately transfused without a significant storage interval (within 24-48 hours of donation) have uniformly high recovery, good survival and preserved function. 5 A single donor platelet concentrate containing approximately 3×10 11 platelets is expected to raise platelet count by 30,000-60,000/µl, while random donor platelets containing approximately 7×10 10 platelets increase the platelet count by 5,000-10,000/µl in an average sized adult. Most institution adopted policies for "standard" platelet dose to give one platelet concentrate / 10 kg of body weight and this should increase the platelet count by approximately 40,000/µl.…”

Section: Discussionmentioning

confidence: 99%

Transfusion effect of random donor platelet and single donor platelet in thrombocytopenic patients at tertiary care hospital of South Gujarat

Unagar

Patel

et al. 2017

Int J Res Med Sci

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Background: Platelet transfusion plays a key role in therapy for the patients with thrombocytopenia. Superiority of Single donor platelet (SDP) over Random donor platelet (RDP) transfusions is largely assumed, but unproven. Platelet Rich Plasma-Platelet concentrate (PRP-PC) and Apheresis-PC were prepared and their therapeutic efficacy were assessed in thrombocytopenic patients.Methods: This study included 60 transfusion episodes consisting of 30 SDP and 30 RDP (147units of RDP). The post transfusion efficacy of transfused platelets was assessed at 1 hour and 24 hours by corrected count increment (CCI) and percentage recovery (PR). Paired ‘t’-test was used for statistical analysis and a probability of p<0.05 was used to reject null hypothesis.Results: The mean platelet dose of SDP (n=30) and RDP (n=30) was 2.86±1.05 x 1011 and 2.36±0.54 x 1011 respectively. The mean platelet increments of SDP at 1 hour and 24 hours were 38±18.1 x 103/μl and 37.3±20.7x 103/μl. The mean platelet increments of RDP at 1 hour and 24 hours were 28.5±11.4 x 103/μl and 26 ±11.6 x 103/μl. The mean CCI of SDP at 1hour and 24 hours were 21.4 ±7.3 x 103/μl and 20.8±7.4 x 103/μl respectively. The mean CCI of RDP at 1hour and 24 hours were 18.5±6.3x 103/μl and 17.4±7.6 x 103/μl respectively.Conclusions: Post-transfusion increments were significantly higher in patients who received SDP as compared to RDP, but the CCI and PR were comparable in both groups of patients.

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“…Alternative strategies do exist for bleeding patients like Emma, including the use of random platelets, local hemorrhage control, and so on. The preemptive use of HLA platelets as a prophylactic against alloimmunization should not be attempted; it creates an undue burden on the population and causes a delay in platelet delivery and associated symptom relief [12,13].…”

Section: Ethically and Clinically Relevant Considerations For Platelementioning

confidence: 99%

Ethical Questions about Platelet Transfusions at the End of Life

Sherbeck

Boss

2016

AMA Journal of Ethics

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This case of platelet transfusion in palliative care illustrates a common dilemma in transfusion medicine: approval of the use of a scarce, yet potentially life-saving, resource. As in this case, these decisions often involve seriously ill patients with acute needs and evolving goals of care. The use of resources to treat the patient at hand must be balanced against maintaining adequate resources to treat future patients. In this setting, the ethical principles of beneficence and social justice are in conflict. CaseDr. J, a second-year resident on the palliative care service, has become quite close to his patient, Emma, a 5-year-old girl with acute lymphoblastic leukemia. Two years ago, Emma completed successful chemotherapy and achieved remission, but a recent bone marrow biopsy showed lymphoblastic infiltration. She was started on a rescue therapy program with little response and underwent a bone marrow transplant. During this relapse, she has been hospitalized on multiple occasions for infections and bleeding, which required blood and platelet transfusions, and is now receiving palliative care for tumor lysis syndrome. It is Emma's medical team's opinion that there is no more that can be done to cure her leukemia, which prompted her transfer to the palliative care service. Shortly after transfer, Emma developed bright red blood per rectum, and Dr. J requested human leukocyte antigen (HLA)-matched platelet transfusion for her to help stop the bleeding.Dr. S, a third-year pathology resident, received Dr. J's request for HLA-matched platelets. Typically, pathologists oversee platelet distribution, since they are the physicians responsible for administering transfusion services in a hospital-maintaining an adequate blood supply, monitoring blood donor and patient-recipient safety, ensuring appropriate blood utilization, and directing the preparation and safe use of blood components according to a hospital's platelet distribution protocol. Since Dr. S oversees a busy transfusion service with many sick patients requiring blood and platelets, one of her duties is to carefully assess each request for these limited resources. She contacts Dr. J and asks for more information about his request. Dr. S explains that HLA-matched

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Single donor versus pooled random donor platelet concentrates

Cited by 76 publications

References 22 publications

Efficacy of prophylactic transfusions using single donor apheresis platelets versus pooled platelet concentrates in AML/MDS patients receiving allogeneic hematopoietic stem cell transplantation

Efficacy of prophylactic transfusions using single donor apheresis platelets versus pooled platelet concentrates in AML/MDS patients receiving allogeneic hematopoietic stem cell transplantation

Transfusion effect of random donor platelet and single donor platelet in thrombocytopenic patients at tertiary care hospital of South Gujarat

Ethical Questions about Platelet Transfusions at the End of Life

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