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Published on: August 24, 2015
Storage medium of platelet transfusions and the risk of transfusion-transmitted bacterial infections
Aukje L Kreuger1,2, Rutger A Middelburg1,2, Jean-Louis H Kerkhoffs1,3
1Center for Clinical Transfusion Research, Sanquin Research, Leiden University Medical Center, Leiden, the Netherlands.
Background:
Transfusion-transmitted bacterial infections (TTBIs) are among the most concerning risks of transfusion of platelet (PLT) concentrates. Storage medium influences bacterial growth dynamics and thereby the sensitivity of screening tests for bacterial contamination.
Study Design And Methods:
The aim of this study was to quantify the association of storage media with the incidence of TTBIs after transfusion of PLT concentrates. In the Netherlands, the choice of storage medium is determined solely by geographic location of the hospital. We compared types of storage medium of all reported cases of TTBIs after transfusion of a PLT concentrate with types of storage medium of all produced PLT concentrates in the Netherlands from 2003 to 2014.
Results:
Fourteen cases of TTBIs were reported, of which 57.1% received a PLT concentrate stored in PLT additive solution (PAS) and 42.9% a PLT concentrate stored in plasma. Of all produced PLT concentrates 22.3% were stored in PAS and 77.7% in plasma. The relative risk of TTBI after transfusion of a PAS-stored PLT concentrate was 4.63 (95% confidence interval [CI], 1.4-16.2) compared to transfusion of a plasma-stored PLT concentrate. The incidence of TTBIs was 22.2 per million (95% CI, 12.1-37.2 per million) transfused buffy coat PLT concentrates.
Conclusion:
Transfusion of PAS-stored PLT concentrates is associated with a fourfold increased incidence of TTBIs, compared to plasma-stored PLT concentrates.
Insights
Transfusion-transmitted bacterial infections (TTBIs) are a significant risk. Platelet concentrates stored in platelet additive solution (PAS) showed a fourfold higher incidence of TTBIs compared to those stored in plasma.
Area of Science:
- Transfusion Medicine
- Microbiology
- Infectious Diseases
Background:
- Transfusion-transmitted bacterial infections (TTBIs) represent a critical risk associated with platelet (PLT) concentrate transfusions.
- The storage medium significantly impacts bacterial proliferation and the efficacy of bacterial contamination screening methods.
Purpose of the Study:
- To quantitatively assess the relationship between PLT concentrate storage media and the occurrence of TTBIs.
- To compare TTBI incidence across different storage media in the Netherlands.
Main Methods:
- Retrospective analysis of all reported TTBI cases following PLT concentrate transfusion in the Netherlands (2003-2014).
- Comparison of storage media (platelet additive solution [PAS] vs. plasma) for TTBI cases against all produced PLT concentrates.
- Calculation of relative risk and incidence rates for TTBIs based on storage medium.
Main Results:
- Fourteen TTBI cases were identified; 57.1% involved PLT concentrates stored in PAS and 42.9% in plasma.
- PAS-stored PLT concentrates constituted 22.3% of all produced units, while plasma-stored units comprised 77.7%.
- A 4.63-fold increased relative risk of TTBI was observed for PAS-stored PLT concentrates compared to plasma-stored ones. The incidence of TTBIs was 22.2 per million transfused buffy coat PLT concentrates.
Conclusions:
- Transfusion of PLT concentrates stored in PAS is linked to a significantly higher incidence of TTBIs.
- The findings suggest a need to re-evaluate storage practices for PLT concentrates to mitigate TTBI risks.
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