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Septic reactions to platelet transfusions. A persistent problem
J F Morrow1, H G Braine, T S Kickler
1Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Md.
Objective:
To determine the medical and laboratory characteristics of bacteremia secondary to transfusion of microbiologically contaminated platelet concentrates.
Design:
Febrile transfusion reactions were prospectively monitored over 42 months. Units involved in reactions were evaluated with Gram's stain and culture tests.
Setting:
Comprehensive cancer center.
Patients:
Patients receiving platelet transfusions for thrombocytopenia secondary to bone marrow failure.
Result:
Seven cases of transfusion-associated sepsis were observed. Multidonor platelet products stored for 5 days resulted in an incidence of sepsis five times higher than those stored for 4 days or less (P less than .01). Investigation indicates that contamination most likely occurred at the time of blood collection. Clinically, septic reactions were associated with greater temperature elevations (average increase, 2.0 degrees C) than febrile reactions to sterile products.
Conclusions:
Contamination of platelet concentrates remains a significant clinical problem. Septic episodes may be reduced by transfusion of platelets with shorter storage intervals.