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Blood Utilization and Transfusion Reactions in Pediatric Patients Transfused with Conventional or Pathogen Reduced

Wade L Schulz1, Jacob McPadden2, Eric A Gehrie3

  • 1Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT.

The Journal of Pediatrics
|March 20, 2019
PubMed

Insights

Pathogen-reduced platelets show similar utilization and safety compared to conventional platelets in pediatric patients. A slight increase in transfusions occurred in older children, but overall outcomes remained comparable across age groups.

Area of Science:

  • Pediatric Hematology
  • Transfusion Medicine
  • Blood Product Safety

Background:

  • Ongoing questions exist regarding the safety and efficacy of pathogen-reduced platelet (PLT) products in pediatric populations.
  • A transition from conventional to pathogen-reduced PLTs necessitates quality assurance reviews of utilization and safety.

Purpose of the Study:

  • To assess the safety and efficacy of Food and Drug Administration-approved pathogen-reduced platelet products in children.
  • To evaluate PLT utilization, red blood cell transfusion trends, and short-term safety of conventional versus pathogen-reduced PLTs in pediatric patients.

Main Methods:

  • A 21-month quality assurance review was conducted at a tertiary care hospital during a transition period.
  • PLT utilization and safety were assessed in neonatal intensive care unit (NICU) patients, infants (0-1 year) outside NICU, and children (1-18 years) (PED).
  • Short-term safety outcomes, including transfusion reactions and red cell utilization, were compared between conventional and pathogen-reduced PLTs.

Main Results:

  • Utilization patterns for conventional and pathogen-reduced PLTs were similar across all pediatric age groups.
  • A statistically significant, though small, increase in subsequent platelet transfusions was observed in PED patients receiving pathogen-reduced PLTs (P < .001).
  • Time to subsequent transfusion, red cell utilization, and transfusion reactions were comparable between the two PLT types in all assessed pediatric groups. No rashes were noted in NICU patients receiving phototherapy and pathogen-reduced PLTs.

Conclusions:

  • Conventional and pathogen-reduced PLTs demonstrate similar utilization and safety profiles in pediatric populations.
  • While a minor increase in transfusions was seen in older children, pathogen-reduced PLTs are a safe alternative for pediatric patients.
  • Further research may explore specific indications or patient subgroups where differences might emerge.
Abstract

Keywords:
pathogen reductionpediatric transfusiontransfusion safety

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