The safety of pathogen-reduced platelet transfusions in critically ill term and preterm neonates.
neonate
pathogen reduced platelet transfusion
Journal
Vox sanguinis
ISSN: 1423-0410
Titre abrégé: Vox Sang
Pays: England
ID NLM: 0413606
Informations de publication
Date de publication:
30 Oct 2024
30 Oct 2024
Historique:
revised:
03
10
2024
received:
04
07
2024
accepted:
12
10
2024
medline:
31
10
2024
pubmed:
31
10
2024
entrez:
30
10
2024
Statut:
aheadofprint
Résumé
Platelet transfusions carry an important risk of infection transmission. The Mirasol Pathogen Reduction Technology system for platelets uses riboflavin and UV light to introduce irreparable lesions into nucleic acids, thereby inhibiting pathogen replication and inactivating white blood cells. The objective of this study is to evaluate the safety of pathogen-reduced platelet transfusions (PRPTs) in critically ill infants in a neonatal intensive care unit (NICU) in the Caribbean. We conducted a descriptive retrospective study of the use of Mirasol PRPTs in patients admitted to the NICU of the general hospital in Curaçao from February 2016 to April 2023. A total of 208 PRPTs were administered to 46 patients (median [range] transfusions per patient: 3 [1-24]). Three patients were born term, and 43 were born preterm (median [range] gestational age: 27 4/7 weeks [24 6/7-36 6/7]). PRPTs were well-tolerated and no complications occurred, especially no signs of haemolysis nor any signs of new infection within 24 h after transfusion. Twenty-one of 46 patients (46%) died during their admittance. None of the deaths were deemed related to PRPT. Mirasol PRPT appears to be safe for use in critically ill neonates, including extremely preterm neonates.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Platelet transfusions carry an important risk of infection transmission. The Mirasol Pathogen Reduction Technology system for platelets uses riboflavin and UV light to introduce irreparable lesions into nucleic acids, thereby inhibiting pathogen replication and inactivating white blood cells. The objective of this study is to evaluate the safety of pathogen-reduced platelet transfusions (PRPTs) in critically ill infants in a neonatal intensive care unit (NICU) in the Caribbean.
MATERIALS AND METHODS
METHODS
We conducted a descriptive retrospective study of the use of Mirasol PRPTs in patients admitted to the NICU of the general hospital in Curaçao from February 2016 to April 2023.
RESULTS
RESULTS
A total of 208 PRPTs were administered to 46 patients (median [range] transfusions per patient: 3 [1-24]). Three patients were born term, and 43 were born preterm (median [range] gestational age: 27 4/7 weeks [24 6/7-36 6/7]). PRPTs were well-tolerated and no complications occurred, especially no signs of haemolysis nor any signs of new infection within 24 h after transfusion. Twenty-one of 46 patients (46%) died during their admittance. None of the deaths were deemed related to PRPT.
CONCLUSION
CONCLUSIONS
Mirasol PRPT appears to be safe for use in critically ill neonates, including extremely preterm neonates.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 International Society of Blood Transfusion.
Références
Levy JH, Neal MD, Herman JH. Bacterial contamination of platelets for transfusion: strategies for prevention. Crit Care. 2018;22:271.
Aubron C, Flint AW, Bailey M, Pilcher D, Cheng AC, Hegarty C, et al. Is platelet transfusion associated with hospital‐acquired infections in critically ill patients? Crit Care. 2017;21:2.
Marschner S, Goodrich R. Pathogen reduction technology treatment of platelets, plasma and whole blood using riboflavin and UV light. Transfus Med Hemother. 2011;38:8–18.
Lu W, Fung M. Platelets treated with pathogen reduction technology: current status and future direction. F1000Res. 2020;9:40.
Reikvam H, Marschner S, Apelseth TO, Goodrich R, Hervig T. The Mirasol Pathogen Reduction Technology system and quality of platelets stored in platelet additive solution. Blood Transfus. 2010;8:186–192.
Liu H, Wang X. Pathogen reduction technology for blood component: a promising solution for prevention of emerging infectious disease and bacterial contamination in blood transfusion services. jJ Photochem Photobiol. 2021;8:100079.
Lasky B, Nolasco J, Graff J, Ward DC, Ziman A, McGonigle AM. Pathogen‐reduced platelets in pediatric and neonatal patients: demographics, transfusion rates, and transfusion reactions. Transfusion. 2021;61:2869–2876.
Patel RM, Josephson C. Neonatal and pediatric platelet transfusions: current concepts and controversies. Curr Opin Hematol. 2019;26:466–472.
Basavarajegowda A, Plakkal N. Transfusion reactions in neonates and pediatrics: how and why are they different? Asian J Transfus Sci. 2023;17:97–102.
CBC People and Society. Central Bureau of Statistics Curaçao. 2023. Available from: https://curacaodata.cbs.cw/people-and-society. Last accessed 5 Jun 2024.
NVOG. Richtlijn Bloedtransfusie. 2011. Available from: https://www.nvog.nl/wp-content/uploads/2018/02/Bloedtransfusie-2.0-11-11-2011.pdf. Last accessed 5 Jun 2024.
Specialisten FM. Bloedtransfusiebeleid. Available from: https://richtlijnendatabase.nl/richtlijn/bloedtransfusiebeleid/trombocytentransfusies/trigger_trombocytentransfusie_neonaten_trombocytopenie.html. Last accessed 5 Jun 2024.
Goodrich RP, Edrich RA, Li J, Seghatchian J. The Mirasol PRT system for pathogen reduction of platelets and plasma: an overview of current status and future trends. Transfus Apher Sci. 2006;35:5–17.
The Guide to the preparation, use and quality assurance of blood components. 21st ed. European Directorate for the Quality of Medicines & HealthCare of the Council of Europe (EDQM); 2023. Available from: https://www.edqm.eu/en/blood-guide. Last accessed 5 Jun 2024.
Delaney M, Andrews J, Virk M, Barber JR, Bost JE, Baech J, et al. Multinational analysis of children transfused with pathogen inactivated platelets. Hosp Pediatr. 2022;12:311–316.
Lim SM, Wever R, Pas SD, Bonofacio G, Koopmans MPG, Martina BEE. Zika virus outbreak on Curaçao and Bonaire, a report based on laboratory diagnostics data. Front Public Health. 2019;7:333.
Marschner S, Fast LD, Baldwin WM 3rd, Slichter SJ, Goodrich RP. White blood cell inactivation after treatment with riboflavin and ultraviolet light. Transfusion. 2010;50:2489–2498.
Fast LD, DiLeone G, Marschner S. Inactivation of human white blood cells in platelet products after pathogen reduction technology treatment in comparison to gamma irradiation. Transfusion. 2011;51:1397–1404.