Impact of the platelet storage time on transfusion-related adverse reactions: A French hemovigilance study

The legal shelf life of platelet concentrates (PCs) has been extended from 5 to 7 days in France since 2018. Our study aimed to determine whether this increase in PC storage time has produced a significant impact on transfusion-related adverse reactions (ARs).

A retrospective study was conducted in the Grand Est region of France between January 2022 and December 2023 using data from the e-FIT hemovigilance database and the record of PCs transfused held by the "Etablissement Français du Sang" (EFS).

In 2022 and 2023, 270 ARs related to platelet transfusions were reported in the Grand Est region of France, 240 of which were classified as possibly, probably or certain attributable to the transfusion. The majority of these immediate ARs were allergies, febrile non-hemolytic transfusion reactions and immunological incompatibilities. We found no significant correlation of the platelet storage time (≤3 days versus 4-7 days) with the three main immediate adverse reactions (p = 0.24), or with isolated alloimmunization (p = 0.55). The storage time did not affect the incidence of ARs following transfusion of either buffy coat PC or apheresis PC (p = 0.20). Finally, no association was observed between the age of PCs and the severity of ARs (p = 0.24).

Our results show that storage of platelets for 4 to 7 days has no significant effect on the occurrence or severity of ARs. Prospective studies will be necessary to assess the impact of platelet storage time on transfusion efficacy and the potential benefit of considering the age of the platelets for certain patients.