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09:49
Routine Screening Method for Microparticles in Platelet Transfusions
Published on: January 31, 2018
Risk-reduction strategies for platelet transfusion in the United States
1Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA. vamvakase@cshs.org
Thescientificworldjournal
|March 16, 2011
Summary
Platelet pathogen reduction systems may reduce transfusion-transmitted infections and sepsis risks. However, they may increase bleeding complications, requiring careful risk-benefit analysis for optimal patient safety.
Area of Science:
- Transfusion Medicine
- Infectious Disease Prevention
- Blood Component Safety
Background:
- Transfusion-associated bacteremia/sepsis (TABS) and transfusion-transmitted infections (TTIs) remain significant risks despite bacterial cultures.
- Emerging TTIs pose a future threat, potentially mirroring past HIV epidemics.
- Platelet pathogen-reduction (PR) systems, licensed in Europe, may soon be available in the U.S.
Purpose of the Study:
- To evaluate alternative strategies for reducing residual risks of TTIs and TABS with future U.S. PR systems.
- To compare risks and benefits of non-pathogen-reduced single-donor platelets, pathogen-reduced single-donor platelets, and pathogen-reduced pooled whole-blood-derived (PWBD) platelets.
- To inform decisions regarding the optimal approach to platelet transfusion safety.
Main Methods:
- Analysis of existing data and potential future strategies for platelet transfusion.
- Comparison of risks associated with different platelet preparation methods (single-donor vs. PWBD, PR vs. non-PR).
- Consideration of adverse events, including bleeding complications and pathogen transmission.
Main Results:
- Single-donor platelets (SDP) reduce TTI and TABS risks twofold compared to PWBD platelets, without added risk.
- PR of platelets may increase mild/moderate bleeding risks and does not eliminate all pathogen risks.
- Multicomponent apheresis using SDP can reduce donor exposures and potentially transfusion-related acute lung injury.
Conclusions:
- Future U.S. strategies may include non-PR SDP, PR SDP, or PR PWBD platelets.
- The choice between PR and non-PR SDP requires precise quantification of PR-associated bleeding risks versus TABS/TTI risks.
- Balancing bleeding risks with infection prevention is crucial for selecting the safest platelet transfusion strategy.
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