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Multinational Analysis of Children Transfused With Pathogen Inactivated Platelets
Meghan Delaney1,2, Jennifer Andrews3, Mrigender Virk4
1Divisions of Pathology and Laboratory Medicine and.
Insights
Pathogen inactivated (PI) platelets showed similar transfusion reaction rates in pediatric patients compared to conventional platelets. Fewer mild allergic reactions were observed with PI platelets, suggesting improved safety in pediatric transfusions.
Area of Science:
- Hematology
- Transfusion Medicine
- Pediatric Blood Safety
Background:
- Pathogen inactivated (PI) platelets represent an advancement in blood safety.
- The safety and efficacy of PI platelets in pediatric populations require further characterization.
Purpose of the Study:
- To evaluate transfusion reaction rates in pediatric patients receiving PI platelets versus conventional platelets.
- To compare the incidence of acute transfusion reactions between PI and conventional platelet transfusions in children.
Main Methods:
- Retrospective, multisite study comparing two time periods: before and after widespread PI platelet use.
- Analysis of suspected acute transfusion reactions in pediatric patients (0-18 years) receiving platelet transfusions.
- Comparison of reaction rates between patients receiving PI platelets and those receiving conventional platelets.
Main Results:
- No significant difference in the overall rate of acute transfusion reactions between PI and conventional platelets (1.0% vs. 1.1%, P = .803).
- A statistically significant reduction in mild allergic reactions was observed during the PI platelet period (0.2% vs. 0.7%, P = .018).
- Study included 3839 pediatric patients and over 7930 platelet transfusions across 4 centers in 3 countries (2013-2019).
Conclusions:
- Pediatric patients experience comparable rates of acute transfusion reactions with PI and conventional platelets.
- The observed decrease in mild allergic reactions may be linked to the broader use of platelet additive solutions.
- Future research should incorporate pediatric populations to fully assess PI platelet efficacy and hemostatic outcomes.
Background:
Pathogen inactivated (PI) platelets are a technological advancement in blood safety; however, the pediatric experience is not well characterized. We studied pediatric patients who received transfusions of PI platelets across several centers and countries to determine if transfusion reaction rates differed when compared with conventional platelets.
Methods:
This is a retrospective multisite study conducted during 2 time periods. The study period started at the time each site began using PI platelets on a widespread basis, and the control period was a similar timespan before PI introduction. Suspected acute transfusion reactions were compared.
Results:
The study included 3839 pediatric patients who were 0 to 18 years of age who received >7930 platelet transfusions, in total, across 4 centers in 3 countries between 2013 and 2019. The age distribution of patients in the study and control period was not significantly different (P = .190). There was not a difference in the percentage of patients who had any type of transfusion reaction between the time periods (1.0% and 1.1%, P = .803). There were fewer patients with mild allergic reactions in the study period compared with the control period (0.2% and 0.7% of patients with reactions, respectively, P = .018).
Conclusions:
Pediatric patients have the same rate of acutely suspected transfusion reactions when receiving PI or conventional platelet transfusions. Subgroup analysis found fewer mild allergic reactions in the study period, which was contemporaneous to the addition of using platelet additive solution more broadly. Future studies of PI platelets should include children to better assess transfusion efficacy and hemostatic outcomes.
