TY - JOUR
T1 - Effect of platelet storage duration on clinical outcomes and incremental platelet change in critically ill children
AU - The Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) network
AU - Pediatric Critical Care Blood Research Network (BloodNet)
AU - P3T Investigators
AU - Nellis, Marianne E.
AU - Spinella, Philip C.
AU - Tucci, Marisa
AU - Stanworth, Simon J.
AU - Steiner, Marie E.
AU - Cushing, Melissa M.
AU - Davis, Peter J.
AU - Karam, Oliver
AU - Butt, Warwick
AU - Delzoppo, Carmel
AU - Erickson, Simon
AU - Croston, Elizabeth
AU - Barr, Samantha
AU - Cavazzoni, Elena
AU - de Jaeger, Annick
AU - French, Mary Ellen
AU - Ropars, Marion
AU - Clayton, Lucy
AU - Murthy, Srinivas
AU - Krahn, Gordon
AU - Qu, Dong
AU - Hui, Yi
AU - Johansen, Mathias
AU - Jensen, Anne Mette Baek
AU - Jarnvig, Inge Lise
AU - Strange, Ditte
AU - Jayashree, Muralidharan
AU - Reddy, Mounika
AU - Sankar, Jhuma
AU - Kumar, U. Vijay
AU - Lodha, Rakesh
AU - Lerner, Reut Kassif
AU - Paret, Gideon
AU - Schiller, Ofer
AU - Shostak, Eran
AU - Dagan, Ovadia
AU - Cavari, Yuval
AU - Chiusolo, Fabrizio
AU - Cillis, Annagrazia
AU - Camporesi, Anna
AU - Kneyber, Martin
AU - Cochius-Den Otter, Suzan
AU - Van Hemeldonck, Ellen
AU - Beca, John
AU - Sherring, Claire
AU - Rea, Miriam
AU - Abadesso, Clara
AU - Moniz, Marta
AU - Alshehri, Saleh
AU - Lopez-Herce, Jesus
N1 - Publisher Copyright:
© 2020 AABB
PY - 2020/12
Y1 - 2020/12
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85091272018&partnerID=8YFLogxK
U2 - 10.1111/trf.16094
DO - 10.1111/trf.16094
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C2 - 32959409
AN - SCOPUS:85091272018
SN - 0041-1132
VL - 60
SP - 2849
EP - 2858
JO - Transfusion
JF - Transfusion
IS - 12
ER -