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Das N, Prakash S, Sahu A, Panigrahi A, Mishra D, Mukherjee S. Impact of dose and storage duration of platelet concentrates on platelet recovery between ABO identical and ABO non-identical random donor platelet transfusions in hemato-oncology patients. Hematol Transfus Cell Ther 2024; 46:228-236. [PMID: 36941173 PMCID: PMC11221252 DOI: 10.1016/j.htct.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/11/2022] [Accepted: 01/16/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES It is challenging to adopt a policy of ABO identical platelet transfusion in hemato-oncological patients because of the high demand. Moreover, there are no global standards for the management of ABO non-identical platelet transfusions due to limited evidence. The current study compared the impact of dose and storage duration of platelets on percent platelet recovery (PPR) at 1 h and 24 h between ABO identical and ABO non-identical platelet transfusions in hemato-oncological conditions. The other objectives were to assess the clinical efficacy and compare adverse reactions between the two groups. METHODS A total of 130 random donor platelet transfusion episodes (81 ABO identical and 49 ABO non-identical) were evaluated in 60 eligible patients with different malignant, as well as non-malignant, hematological conditions. All analysis was performed using two-sided tests, and p-values <0.05 were considered significant. RESULTS The PPR at 1 h and 24 h was significantly higher in ABO identical platelet transfusion. Platelet recovery and survival were not affected by the gender, dose or storage duration of platelet concentrate. Aplastic anemia and myelodysplastic syndrome (MDS) disease conditions were observed to be independent risk predictors for 1-h post-transfusion refractoriness. CONCLUSION ABO identical platelets have higher platelet recovery and survival. Both ABO identical and ABO non-identical platelet transfusions have similar efficacy in controlling bleeding episodes up to World Health Organization (WHO) grade two. Assessment of other factors, such as platelet functional properties in the donor, anti-HLA and anti-HPA antibodies, may be needed to better understand the platelet efficacy of platelet transfusions.
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Affiliation(s)
- Niladri Das
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Satya Prakash
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ansuman Sahu
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ashutosh Panigrahi
- Department of Medical Oncology Haematology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Debasish Mishra
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Somnath Mukherjee
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
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Garraud O, Hamzeh-Cognasse H, Chalayer E, Duchez AC, Tardy B, Oriol P, Haddad A, Guyotat D, Cognasse F. Platelet transfusion in adults: An update. Transfus Clin Biol 2023; 30:147-165. [PMID: 36031180 DOI: 10.1016/j.tracli.2022.08.147] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many patients worldwide receive platelet components (PCs) through the transfusion of diverse types of blood components. PC transfusions are essential for the treatment of central thrombocytopenia of diverse causes, and such treatment is beneficial in patients at risk of severe bleeding. PC transfusions account for almost 10% of all the blood components supplied by blood services, but they are associated with about 3.25 times as many severe reactions (attributable to transfusion) than red blood cell transfusions after stringent in-process leukoreduction to less than 106 residual cells per blood component. PCs are not homogeneous, due to the considerable differences between donors. Furthermore, the modes of PC collection and preparation, the safety precautions taken to limit either the most common (allergic-type reactions and febrile non-hemolytic reactions) or the most severe (bacterial contamination, pulmonary lesions) adverse reactions, and storage and conservation methods can all result in so-called PC "storage lesions". Some storage lesions affect PC quality, with implications for patient outcome. Good transfusion practices should result in higher levels of platelet recovery and efficacy, and lower complication rates. These practices include a matching of tissue ABH antigens whenever possible, and of platelet HLA (and, to a lesser extent, HPA) antigens in immunization situations. This review provides an overview of all the available information relating to platelet transfusion, from donor and donation to bedside transfusion, and considers the impact of the measures applied to increase transfusion efficacy while improving safety and preventing transfusion inefficacy and refractoriness. It also considers alternatives to platelet component (PC) transfusion.
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Affiliation(s)
- O Garraud
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France.
| | | | - E Chalayer
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Saint-Etienne University Hospital, Department of Hematology and Cellular Therapy, Saint-Étienne, France
| | - A C Duchez
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
| | - B Tardy
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; CHU de Saint-Etienne, INSERM and CIC EC 1408, Clinical Epidemiology, Saint-Étienne, France
| | - P Oriol
- CHU de Saint-Etienne, INSERM and CIC EC 1408, Clinical Epidemiology, Saint-Étienne, France
| | - A Haddad
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Sacré-Cœur Hospital, Beirut, Lebanon; Lebanese American University, Beirut, Lebanon
| | - D Guyotat
- Saint-Etienne University Hospital, Department of Hematology and Cellular Therapy, Saint-Étienne, France
| | - F Cognasse
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
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3
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Mi Z, Gong L, Kong Y, Zhao P, Yin Y, Xu H, Tian L, Liu Z. Differential expression of exosomal microRNAs in fresh and senescent apheresis platelet concentrates. Platelets 2022; 33:1260-1269. [PMID: 35968647 DOI: 10.1080/09537104.2022.2108541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Patients have a high risk of suffering adverse reactions after receiving platelet products stored for 5 days. Bioactive exosomes in platelet products can be accumulated during storage, which is associated with adverse reactions. MicroRNAs are one of the critical cargoes in exosomes, which participate in cell differentiation, metabolism, and immunomodulation. This study intends to elucidate and analyze the differential expression of exosomal microRNAs in apheresis platelet concentrates during storage and predict the potential functions of target genes. Apheresis platelet concentrates were used to isolate exosomes by ultracentrifugation. Exosomes were phenotyped by western blot, transmission electron microscopy, and nano flow cytometry. The differential expression of the exosomal microRNAs was obtained by a microarray test using four bags of apheresis platelets stored for 5 days compared with 1 day. The differentially expressed microRNAs between the two time points were identified, and their target genes were analyzed by miRWalk and miRDB. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to predict the target genes' functions. Fifteen bags of apheresis platelet concentrates stored for 1 day and 5 days were used to verify the microarray results by quantitative reverse transcription-polymerase chain reactions (qRT-PCR). There were 134 microRNAs in total expressed differently in the two groups (day 1 and day 5), with 57 microRNAs up-regulated and 77 down-regulated (|fold change| > 2.0 and P < .05). Thirteen up-regulated microRNAs (hsa-miR-22-3p, hsa-miR-223-3p, hsa-miR-21-5p, hsa-miR-23a-3p, hsa-miR-320b, hsa-let-7a-5p, hsa-miR-25-3p, hsa-miR-126-3p, hsa-miR-320c, hsa-miR-342-3p, hsa-miR-320d, hsa-miR-328-3p, and hsa-miR-320e) detected in all samples were selected to validate the results. The qRT-PCR results showed that five (hsa-miR-22-3p, hsa-miR-223-3p, hsa-miR-21-5p, hsa-miR-23a-3p, and hsa-miR-320b) of them were increased more than 10-fold (P < .001); four (hsa-let-7a-5p, hsa-miR-25-3p, hsa-miR-126-3p, hsa-miR-320c) more than five-fold (P < .001); two (hsa-miR-342-3p and hsa-miR-320d) more than two-fold (P < .05); and two (hsa-miR-328-3p and hsa-miR-320e) more than two-fold (P > .05). Specifically, hsa-miR-22-3p increased 14.6-fold; hsa-miR-223-3p increased 13.0-fold; and hsa-miR-21-5p increased 12.0-fold. Based on bioinformatics functional analysis, target genes of top nine microRNAs (hsa-miR-22-3p, hsa-miR-223-3p, hsa-miR-21-5p, hsa-miR-23a-3p, hsa-miR-320b, hsa-let-7a-5p, hsa-miR-25-3p, hsa-miR-126-3p, and hsa-miR-320c) were annotated with positive regulation of cell proliferation and nervous system development, and mainly enriched in regulating pluripotency of stem cells signaling pathway, prolactin signaling pathway, and FoxO signaling pathway, etc. The prolactin, FoxO, ErbB, and TNF signaling pathway were relevant to immunomodulation. In particular, hsa-miR-22-3p expression was the most different during storage, with a fold change of 14.6, which might be a key mediator.
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Affiliation(s)
- Ziyue Mi
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, SC, China.,Key Laboratory of Transfusion Adverse Reactions, Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, SC, China
| | - Li Gong
- Key Laboratory of Transfusion Adverse Reactions, Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, SC, China.,School of Public Health, Anhui Medical University, Hefei, AH, China
| | - Yujie Kong
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, SC, China.,Key Laboratory of Transfusion Adverse Reactions, Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, SC, China
| | - Peizhe Zhao
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, SC, China.,Key Laboratory of Transfusion Adverse Reactions, Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, SC, China
| | - Yonghua Yin
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, SC, China.,Key Laboratory of Transfusion Adverse Reactions, Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, SC, China
| | - Haixia Xu
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, SC, China.,Key Laboratory of Transfusion Adverse Reactions, Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, SC, China
| | - Li Tian
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, SC, China.,Key Laboratory of Transfusion Adverse Reactions, Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, SC, China
| | - Zhong Liu
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, SC, China.,Key Laboratory of Transfusion Adverse Reactions, Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, SC, China
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4
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Kracalik I, Mowla S, Basavaraju SV, Sapiano MRP. Transfusion-related adverse reactions: Data from the National Healthcare Safety Network Hemovigilance Module - United States, 2013-2018. Transfusion 2021; 61:1424-1434. [PMID: 33880771 DOI: 10.1111/trf.16362] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/03/2021] [Accepted: 01/23/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Despite current blood safety measures, transfusion recipients can experience transfusion-related adverse reactions. Monitoring these reactions can aid in understanding the effectiveness of current transfusion safety measures. Data from the National Healthcare Safety Network Hemovigilance Module were used to quantify adverse reaction risk. METHODS Facilities reporting at least one month of transfused blood components and transfusion-related adverse reactions during January 2013-December 2018 were included. Adverse reaction rates (number per 100,000 components transfused) were calculated for transfused components stratified by component type, collection, and modification methods. RESULTS During 2013-2018, 201 facilities reported 18,308 transfusion-related adverse reactions among 8.34 million blood components transfused (220/100,000). Adverse reactions were higher among apheresis (486/100,000) and pathogen-reduced platelets (579/100,000) than apheresis red blood cells (197/100,000). Allergic reactions (41%) were most common. There were 23 fatalities and 9% of all adverse reactions were serious (severe, life-threatening, or fatal). Reactions involving pulmonary complications (transfusion-associated circulatory overload, transfusion-related acute lung injury and transfusion-associated dyspnea) accounted for 35% of serious reactions but 65% of fatalities. Most (76%) of the 37 transfusion-transmitted infections were serious; none involved pathogen-reduced components. CONCLUSIONS One in 455 blood components transfused was associated with an adverse reaction although the risk of serious reactions (1 in 6224) or transfusion-transmitted infections (1 in 225,440) was lower. Some serious reactions identified were preventable, suggesting additional safety measures may be beneficial. Higher reaction rates identified among pathogen-reduced platelets require further study. These findings highlight the importance of monitoring reactions through national hemovigilance to inform current safety measures and the need for strategies to increase healthcare facility participation.
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Affiliation(s)
- Ian Kracalik
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sanjida Mowla
- Oak Ridge Institute for Science and Education (ORISE), Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sridhar V Basavaraju
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mathew R P Sapiano
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Lantana Consulting Group, Inc., East Thetford, Vermont, USA
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5
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Wood B, Padula MP, Marks DC, Johnson L. The immune potential of ex vivo stored platelets: a review. Vox Sang 2020; 116:477-488. [PMID: 33326606 DOI: 10.1111/vox.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/14/2020] [Accepted: 12/02/2020] [Indexed: 11/30/2022]
Abstract
Platelets are now acknowledged as key regulators of the immune system, as they are capable of mediating inflammation, leucocyte recruitment and activation. This activity is facilitated through platelet activation, which induces significant changes in the surface receptor profile and triggers the release of a range of soluble biological response modifiers (BRMs). In the field of transfusion medicine, the immune function of platelets has gained considerable attention as this may be linked to the development of adverse transfusion reactions. Further, component manufacturing and storage methodologies may impact the immunoregulatory role of platelets, and an understanding of this impact is crucial and should be considered alongside their haemostatic characteristics. This review highlights the key interactions between platelets and traditional immune modulators. Further, the potential impact of current and novel component storage methodologies, such as refrigeration and cryopreservation, on this functional capacity is examined, highlighting why further knowledge in this area would be of benefit.
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Affiliation(s)
- Ben Wood
- Research & Development, Australian Red Cross Lifeblood, Alexandria, NSW, Australia.,School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - Matthew P Padula
- School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - Denese C Marks
- Research & Development, Australian Red Cross Lifeblood, Alexandria, NSW, Australia.,Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
| | - Lacey Johnson
- Research & Development, Australian Red Cross Lifeblood, Alexandria, NSW, Australia
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6
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Nellis ME, Spinella PC, Tucci M, Stanworth SJ, Steiner ME, Cushing MM, Davis PJ, Karam O. Effect of platelet storage duration on clinical outcomes and incremental platelet change in critically ill children. Transfusion 2020; 60:2849-2858. [PMID: 32959409 DOI: 10.1111/trf.16094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/10/2020] [Accepted: 07/27/2020] [Indexed: 12/15/2022]
Abstract
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 (P = .610). After patient and product variables were adjusted for, there was no association between storage age and incremental change in total PLT count or organ dysfunction scoring. A significant association between fresher storage age and febrile transfusion reactions (P = .002) was observed. CONCLUSION The results in a large, diverse cohort of critically ill children raise questions about the impact of storage age on transfusion and clinical outcomes which require further prospective evaluation.
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Affiliation(s)
- Marianne E Nellis
- Pediatric Critical Care Medicine, NY Presbyterian Hospital-Weill Cornell Medicine, New York, New York
| | - Philip C Spinella
- Department of Pediatrics, Division of Critical Care, Washington University in St Louis, St Louis, Missouri
| | - Marisa Tucci
- Pediatric Intensive Care Unit, CHU Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
| | - Simon J Stanworth
- Transfusion Medicine, NHS Blood and Transplant, Oxford, UK.,Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Radcliffe Department of Medicine, University of Oxford and Oxford BRC Haematology Theme, Oxford, UK
| | - Marie E Steiner
- Divisions of Pediatric Critical Care and Pediatric Hematology/Oncology, University of Minnesota, Minneapolis, Minnesota
| | | | - Peter J Davis
- Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Bristol, UK
| | - Oliver Karam
- Division of Pediatric Critical Care Medicine, Children's Hospital of Richmond at VCU, Richmond, Virginia
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7
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Bai SJ, Zeng B, Zhang L, Huang Z. Autologous Platelet-Rich Plasmapheresis in Cardiovascular Surgery: A Narrative Review. J Cardiothorac Vasc Anesth 2020; 34:1614-1621. [DOI: 10.1053/j.jvca.2019.07.129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/12/2019] [Accepted: 07/14/2019] [Indexed: 01/08/2023]
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8
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Chen B, Xia R. Pro‐inflammatory effects after platelet transfusion: a review. Vox Sang 2020; 115:349-357. [PMID: 32293034 DOI: 10.1111/vox.12879] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/24/2019] [Accepted: 12/03/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Bin‐Zhen Chen
- Department of Transfusion Medicine Huashan Hospital Fudan University Shanghai China
| | - Rong Xia
- Department of Transfusion Medicine Huashan Hospital Fudan University Shanghai China
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9
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Yamanaka M, Yanagisawa R, Kojima S, Nakazawa H, Shimodaira S. Investigation of factors associated with allergic transfusion reaction due to platelet transfusion and the efficacy of platelets resuspended in BRS-A in adult patients. Transfusion 2019; 59:3405-3412. [PMID: 31532542 DOI: 10.1111/trf.15527] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 08/16/2019] [Accepted: 08/18/2019] [Indexed: 12/13/2022]
Abstract
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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Affiliation(s)
- Manjiro Yamanaka
- Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan
| | - Ryu Yanagisawa
- Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan.,Center for Advanced Cell Therapy, Shinshu University Hospital, Matsumoto, Japan
| | - Shunsuke Kojima
- Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan.,Center for Advanced Cell Therapy, Shinshu University Hospital, Matsumoto, Japan
| | - Hideyuki Nakazawa
- Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shigetaka Shimodaira
- Department of Regenerative Medicine, Kanazawa Medical University, Uchinada, Japan
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10
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Hout FM, Middelburg RA, Meer PF, Pors A, Wiersum‐Osselton JC, Schipperus MR, Kerkhoffs J, Bom JG. Effect of storage of platelet concentrates in PAS‐B, PAS‐C, or plasma on transfusion reactions. Transfusion 2019; 59:3140-3145. [DOI: 10.1111/trf.15497] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 04/09/2019] [Accepted: 06/06/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Fabienne M.A. Hout
- Center for Clinical Transfusion ResearchSanquin/LUMC Leiden The Netherlands
- Department of Clinical EpidemiologyLeiden University Medical Center Leiden The Netherlands
| | - Rutger A. Middelburg
- Center for Clinical Transfusion ResearchSanquin/LUMC Leiden The Netherlands
- Department of Clinical EpidemiologyLeiden University Medical Center Leiden The Netherlands
| | - Pieter F. Meer
- Center for Clinical Transfusion ResearchSanquin/LUMC Leiden The Netherlands
| | - Aad Pors
- Center for Clinical Transfusion ResearchSanquin/LUMC Leiden The Netherlands
| | - Johanna C. Wiersum‐Osselton
- Transfusion and Transplantation Reactions in Patients, Dutch National Hemovigilance and Biovigilance Office Leiden The Netherlands
| | - Martin R. Schipperus
- Transfusion and Transplantation Reactions in Patients, Dutch National Hemovigilance and Biovigilance Office Leiden The Netherlands
- Department of HematologyHaga Teaching Hospital The Hague The Netherlands
| | - Jean‐Louis Kerkhoffs
- Center for Clinical Transfusion ResearchSanquin/LUMC Leiden The Netherlands
- Department of HematologyHaga Teaching Hospital The Hague The Netherlands
| | - Johanna G. Bom
- Center for Clinical Transfusion ResearchSanquin/LUMC Leiden The Netherlands
- Department of Clinical EpidemiologyLeiden University Medical Center Leiden The Netherlands
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11
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Pollak U, Ruderman T, Borik-Chiger S, Mishaly D, Serraf A, Vardi A. Transfusion-related acute hepatic injury following postoperative platelets administration in pediatric patients undergoing the Fontan procedure. CONGENIT HEART DIS 2019; 14:968-977. [PMID: 31343842 DOI: 10.1111/chd.12825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/11/2019] [Accepted: 07/08/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The final common pathway of single ventricle patients is the Fontan procedure. Among the immediate postoperative complications is acute hepatic injury presented by marked elevation of liver enzymes (alanine transaminase [ALT] and aspartate transaminase [AST]). We aimed to determine the contribution of blood products transfusion to acute hepatic injury. DESIGN Single center retrospective cohort study. SETTING Pediatric Cardiac Intensive Care Unit at a tertiary medical center. PATIENTS Ninety-nine pediatric patients undergoing the Fontan procedure between January 2009 and December 2016. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Out of the four types of blood products, transfusion of platelets was found to significantly affect postoperative levels of ALT and AST. Additional factors included postoperative administration of sodium bicarbonate, decreased flow through the Fontan canal and decreased urine output. Preoperative pulmonary artery pressure and pulmonary vascular resistance, cardiopulmonary bypass time, aortic cross-clamp time, amount of postoperative bleeding, and vasoactive-inotropic score did not influence liver enzymes levels CONCLUSIONS: In pediatric Fontan patients, platelets transfusions contribute to an acute hepatic injury. The relation between platelets and transfusion-related acute lung injury (TRALI) has been well described, but this is the first time it is being described in regard to acute hepatic injury (TRAHI). Changing platelet transfusion strategy could decrease morbidity in Fontan patients but further research is needed.
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Affiliation(s)
- Uri Pollak
- Pediatric Cardiac Critical Care Unit, Hadassah University Medical Center, Jerusalem, Israel.,Pediatric Cardiology, Hadassah University Medical Center, Jerusalem, Israel.,Pediatric Extracorporeal Support Program, Hadassah University Medical Center, Jerusalem, Israel.,The Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Tatyana Ruderman
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Borik-Chiger
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Cardiology, Edmond J Safra International Congenital Heart Center, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - David Mishaly
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric and Congenital Cardiac Surgery, Edmond J Safra International Congenital Heart Center, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Alain Serraf
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric and Congenital Cardiac Surgery, Edmond J Safra International Congenital Heart Center, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Amir Vardi
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Cardiac Intensive Care Unit, Edmond J Safra International Congenital Heart Center, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel
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Ikebe E, Matsuoka S, Tanaka A, Yonemura Y, Fujii Y, Ohsaka A, Okazaki H, Kitazawa J, Ohtani S, Nakayama T, Momose SY, Miwa I, Taira R, Toyota K, Kino S, Kato H, Hamaguchi I. Reduction in adverse transfusion reactions with increased use of washed platelet concentrates in Japan-A retrospective multicenter study. Transfus Apher Sci 2019; 58:162-168. [PMID: 30670326 DOI: 10.1016/j.transci.2018.12.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/27/2018] [Accepted: 12/31/2018] [Indexed: 12/28/2022]
Abstract
Plasma removal by washing platelet concentrates (PCs) is effective in preventing adverse reactions to PC transfusions. The Japanese Red Cross Society (JRCS) started releasing washed PCs (WPCs) as a commercially approved blood product in September 2016. This retrospective multicenter study investigated the change in the number of transfused WPCs and the impact on the incidence of adverse reactions to PCs before and after the release. The numbers and types of transfused PCs and the adverse reactions to the PCs for a year before the start of the WPC release and for a year after the release were reported by 27 medical institutes in Japan. Transfusion information for approximately 8% of the amount of PCs supplied in Japan was analyzed during the study period. After the start of WPC release by the JRCS, the number of transfused WPCs doubled. The rate of adverse reactions to PCs decreased significantly (p = 0.0223), from 4.30% before the release to 4.05% after the release. The rates of adverse reactions to unwashed and WPCs were 4.13% and 0.84%, respectively. Allergic adverse reactions were significantly decreased after the release (3.60% before versus 3.37% after). No severe allergic reactions to WPCs were reported. The release of WPCs by the JRCS significantly reduced transfusion-related adverse reactions to PCs in Japan.
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Affiliation(s)
- Emi Ikebe
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Sahoko Matsuoka
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Asashi Tanaka
- Department of Blood Transfusion, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Yuji Yonemura
- Department of Transfusion Medicine and Cell Therapy, Kumamoto University Hospital, Kumamoto, Japan
| | - Yasuhiko Fujii
- Department of Transfusion Medicine, Yamaguchi University Hospital, Yamaguchi, Japan
| | - Akimichi Ohsaka
- Department of Transfusion Medicine and Stem Cell Regulation, Juntendo University School of Medicine, Tokyo, Japan
| | - Hitoshi Okazaki
- Department of Transfusion Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Junichi Kitazawa
- Department of Transfusion Medicine and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan; Division of Clinical Laboratory, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Shinichi Ohtani
- Department of Transfusion Medicine and Cell Transplantation, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takayuki Nakayama
- Department of Transfusion Medicine, Aichi Medical University, Aichi, Japan
| | - Shun-Ya Momose
- Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
| | - Izumi Miwa
- Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Rikizo Taira
- Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Kuro Toyota
- Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Shuichi Kino
- Japanese Red Cross Hokkaido Block Blood Center, Sapporo, Japan
| | - Hidefumi Kato
- Department of Transfusion Medicine, Aichi Medical University, Aichi, Japan
| | - Isao Hamaguchi
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan.
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13
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Hegde S, Akbar H, Zheng Y, Cancelas JA. Towards increasing shelf life and haemostatic potency of stored platelet concentrates. Curr Opin Hematol 2018; 25:500-508. [PMID: 30281037 PMCID: PMC6532779 DOI: 10.1097/moh.0000000000000456] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
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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Affiliation(s)
- Shailaja Hegde
- Hoxworth Blood Center, University of Cincinnati Academic Health Center
| | - Huzoor Akbar
- Division of Experimental Hematology and Cancer Biology, Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati
- Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Yi Zheng
- Division of Experimental Hematology and Cancer Biology, Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati
| | - Jose A. Cancelas
- Hoxworth Blood Center, University of Cincinnati Academic Health Center
- Division of Experimental Hematology and Cancer Biology, Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati
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14
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Humbrecht C, Kientz D, Gachet C. Platelet transfusion: Current challenges. Transfus Clin Biol 2018; 25:151-164. [PMID: 30037501 DOI: 10.1016/j.tracli.2018.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 12/29/2022]
Abstract
Since the late sixties, platelet concentrates are transfused to patients presenting with severe thrombocytopenia, platelet function defects, injuries, or undergoing surgery, to prevent the risk of bleeding or to treat actual hemorrhage. Current practices differ according to the country or even in different hospitals and teams. Although crucial advances have been made during the last decades, questions and debates still arise about the right doses to transfuse, the use of prophylactic or therapeutic strategies, the nature and quality of PC, the storage conditions, the monitoring of transfusion efficacy and the microbiological and immunological safety of platelet transfusion. Finally, new challenges are emerging with potential new platelet products, including cold stored or in vitro produced platelets. The most debated of these points are reviewed.
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Affiliation(s)
- C Humbrecht
- Établissement français du sang grand est, 85-87, boulevard Lobau, 54064 Nancy cedex, France.
| | - D Kientz
- Établissement français du sang grand est, 85-87, boulevard Lobau, 54064 Nancy cedex, France
| | - C Gachet
- Établissement français du sang grand est, 85-87, boulevard Lobau, 54064 Nancy cedex, France.
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