Evaluating safety and cost-effectiveness of platelets stored in additive solution (PAS-F) as a hemolysis risk mitigation strategy.


Journal

Transfusion
ISSN: 1537-2995
Titre abrégé: Transfusion
Pays: United States
ID NLM: 0417360

Informations de publication

Date de publication:
04 2019
Historique:
received: 03 09 2018
revised: 11 11 2018
accepted: 29 11 2018
pubmed: 29 12 2018
medline: 7 5 2020
entrez: 29 12 2018
Statut: ppublish

Résumé

Platelet inventory constraints can result in minor ABO incompatibility and possible hemolysis. The aims of this study were to determine the reduction of isoagglutinin in titers of platelets stored in additive solution (PAS) and compare its safety, efficiency, and cost-effectiveness with full-volume and plasma-reduced platelets. Isoagglutinin titers were performed in paired whole blood donor samples and apheresis platelets collected in PAS (PAS-PLT) aliquot samples by the tube method. A total of 149 pairs of donor/platelet samples were tested: 75 group O, 59 group A, and 15 group B. For group O donor samples, the median anti-A IgG and IgM were 64 and 16, respectively, and the median anti-B IgG and IgM were 64 and 16, respectively. For group O PAS-PLT samples the mean anti-A IgG and IgM, and anti-B IgG and IgM were 32 and 8, and 16 and 8, respectively. For group A donor samples, the mean anti-B IgG and IgM was 8 in both cases; and both titers decreased to 2 in PAS-PLT. For group B donor samples, mean anti-A IgG and IgM was 16 in both cases; and both titers decreased to 4 in PAS-PLT. PAS-PLT demonstrated a net reduction in cost and improved efficiency when compared to plasma reduction. The use of PAS-PLT resulted in a 40% reduction of allergic transfusion reactions. The use of PAS decreases plasma isoagglutinin titers, transfusion reactions, and is cost-effective when compared to routine plasma reduction as a strategy to mitigate hemolysis risk from minor incompatible platelet transfusion.

Sections du résumé

BACKGROUND
Platelet inventory constraints can result in minor ABO incompatibility and possible hemolysis. The aims of this study were to determine the reduction of isoagglutinin in titers of platelets stored in additive solution (PAS) and compare its safety, efficiency, and cost-effectiveness with full-volume and plasma-reduced platelets.
STUDY DESIGN AND METHODS
Isoagglutinin titers were performed in paired whole blood donor samples and apheresis platelets collected in PAS (PAS-PLT) aliquot samples by the tube method.
RESULTS
A total of 149 pairs of donor/platelet samples were tested: 75 group O, 59 group A, and 15 group B. For group O donor samples, the median anti-A IgG and IgM were 64 and 16, respectively, and the median anti-B IgG and IgM were 64 and 16, respectively. For group O PAS-PLT samples the mean anti-A IgG and IgM, and anti-B IgG and IgM were 32 and 8, and 16 and 8, respectively. For group A donor samples, the mean anti-B IgG and IgM was 8 in both cases; and both titers decreased to 2 in PAS-PLT. For group B donor samples, mean anti-A IgG and IgM was 16 in both cases; and both titers decreased to 4 in PAS-PLT. PAS-PLT demonstrated a net reduction in cost and improved efficiency when compared to plasma reduction. The use of PAS-PLT resulted in a 40% reduction of allergic transfusion reactions.
CONCLUSION
The use of PAS decreases plasma isoagglutinin titers, transfusion reactions, and is cost-effective when compared to routine plasma reduction as a strategy to mitigate hemolysis risk from minor incompatible platelet transfusion.

Identifiants

pubmed: 30592057
doi: 10.1111/trf.15138
doi:

Substances chimiques

ABO Blood-Group System 0
Hemagglutinins 0

Types de publication

Evaluation Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1246-1251

Informations de copyright

© 2018 AABB.

Auteurs

Monica B Pagano (MB)

Department of Laboratory Medicine, Division of Transfusion Medicine, University of Washington, Seattle, Washington.

Brennan L Katchatag (BL)

Department of Laboratory Medicine, Division of Transfusion Medicine, Harborview Medical Center, Seattle, Washington.

Shiva Khoobyari (S)

Department of Laboratory Medicine, Division of Transfusion Medicine, University of Washington, Seattle, Washington.

Mark Van Gerwen (M)

Department of Laboratory Medicine, Division of Transfusion Medicine, University of Washington, Seattle, Washington.

Nina Sen (N)

Department of Laboratory Medicine, Division of Transfusion Medicine, Harborview Medical Center, Seattle, Washington.

N Rebecca Haley (N)

Bloodworks Northwest, Seattle, Washington.

Terry B Gernsheimer (TB)

Department of Medicine, Division of Hematology, University of Washington, Seattle, Washington.

John R Hess (JR)

Department of Laboratory Medicine, Division of Transfusion Medicine, Harborview Medical Center, Seattle, Washington.

Ryan A Metcalf (RA)

ARUP, University of Utah, Salt Lake City, Utah.

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Classifications MeSH