Platelet transfusion reactions do not occur more often in recipients transfused with apheresis versus buffy coat platelet concentrates

Background/Aim. Transfusion reaction is an adverse event which manifests during or after administration of blood components to the patient. We aimed to show less known aspects of most common transfusion reactions (allergic and febrile non-hemolytic transfusion reactions ? FNHTR) in the pediatric population at the platelet concentrates. The aim of this study was to determine the role of the accumulated cytokines interleukin-6 (IL-6), interlekin- 8 (IL-8) and presence of anti-platelet antibodies in the etiology of transfusion reaction in children. Methods. The study included 239 pediatric patients, who received platelet concentrates. Data of reported transfusion reaction were collected and evaluated prospectively. The levels of IL-6 and IL-8 were determined using an immunoassay. Antihuman leukocyte antigen antibodies (anti-HLA) and antihuman platelet antigen antibodies (anti-HPA) were identified by Luminex flow cytometry. Results. Toral of 70 transfusion reactions were recorded 52 patients. Allergic reactions occurred in most of the cases (74.3%), followed by FNHTR (17.1%). Platelets derived from buffy coat caused the majority of reactions (73.5%). Patients with infection after platelet transfusion with FNHTR had the highest levels of IL-6, 483.30 ? 1,041.79 pg/mL (p = 0.020). Respectively, the febrile patients had IL-6, 302.52 ? 720.04 pg/mL (p = 0.004). The level of IL-8 in platelet units that caused transfusion reactions was 95.66 ? 319.10 pg/mL, which was significantly higher (p = 0.001) compared to the control platelet units. Conclusion. The predominant etiologic mechanism for FNHTR in our study was leukocyte derived cytokine accumulation during storage. Etiopathogenesis of FNHTR induced by IL-6 and IL- 8 presented differently. We concluded that significant factors in the etiology of FNHTR by IL-6 were the factors related to the pediatric patient (infection, inflammation).

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Administration of platelet concentrates suspended in bicarbonated Ringer's solution in children who had platelet transfusion reactions

Vox Sanguinis ◽

10.1111/vox.12608 ◽

2017 ◽

Vol 113 (2) ◽

pp. 128-135 ◽

Cited By ~ 8

Author(s):

J. Kobayashi ◽

R. Yanagisawa ◽

T. Ono ◽

Y. Tatsuzawa ◽

Y. Tokutake ◽

...

Keyword(s):

Platelet Transfusion ◽

Platelet Concentrates ◽

Ringer’S Solution ◽

Transfusion Reactions

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Correction of poor platelet transfusion responses with leukocyte-poor HL-A-matched platelet concentrates

Blood ◽

10.1182/blood.v46.5.743.bloodjournal465743 ◽

1975 ◽

Vol 46 (5) ◽

pp. 743-750 ◽

Cited By ~ 1

Author(s):

RH Herzig ◽

GP Herzig ◽

MI Bull ◽

JA Decter ◽

HP Lohrmann ◽

...

Keyword(s):

Blood Cells ◽

Platelet Transfusion ◽

White Blood Cells ◽

Innocent Bystander ◽

Platelet Concentrates ◽

Simple Method ◽

The Poor ◽

Starting Point ◽

Antigen Antibody ◽

Transfusion Reactions

Matching donor-recipient pairs for HL-A antigens provides a logical starting point for selecting donors for recipients with extensive prior transfusion histories. However, during the course of continued exposure to even HL-A-matched platelet concentrates, further sensitization occurs, as indicated by progressively poorer post-transfusion increments and transfusion reactions. There is evidence that such sensitization may be due to non-HL-A antigens. Finally, it is postulated that the poor post-transfusion platelet increments obtained when standard platelet concentrates are used result from the leukoagglutinin antigen-antibody reaction involving the platelet as an “innocent bystander.” The standard platelet concentrate can be purified by a simple method of centrifugation (178 g times 3 min), removing about 96% of the contaminating white blood cells with concomitant loss of about 21% of the platelets. The use of these leukocyte-poor platelet concentrates can restore compatible transfusion increments in highly alloimmunized thrombocytopenic recipients. The luekocyte-poor concentrates can diminish undesirable transfusion reactions following imcompatible platelet transfusions.

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A multicenter randomized study of the efficacy of transfusions with platelets stored in platelet additive solution II versus plasma

Blood ◽

10.1182/blood-2006-04-020131 ◽

2006 ◽

Vol 108 (9) ◽

pp. 3210-3215 ◽

Cited By ~ 96

Author(s):

Jean-Louis H. Kerkhoffs ◽

Jeroen C. Eikenboom ◽

Martin S. Schipperus ◽

Rinie J. van Wordragen-Vlaswinkel ◽

Ronald Brand ◽

...

Keyword(s):

Multivariate Analysis ◽

Clinical Efficacy ◽

Randomized Study ◽

Buffy Coat ◽

Bleeding Complications ◽

Platelet Concentrates ◽

Storage Medium ◽

Clinical Complications ◽

Additive Solution ◽

Transfusion Reactions

Abstract Randomized studies testing the clinical efficacy of platelet additive solutions (PASs) for storage of platelets are scarce and often biased by patient selection. We conducted a multicenter, randomized study to investigate clinical efficacy of platelets stored in PAS II versus plasma, also including patients with clinical complications associated with increased platelet consumption. A total of 168 evaluable patients received pooled buffy coat–derived platelet concentrates (PCs) suspended in either plasma (n = 354) or PAS II (n = 411) stored up to 5 days. Both univariate as well as multivariate analysis showed a significant effect of used storage medium in regard to 1- and 24-hour count increments and corrected count increments, in favor of plasma PCs. However, there were no significant differences between the groups regarding bleeding complications and transfusion interval. Adverse transfusion reactions occurred significantly less after transfusions with PAS II PCs (P = .04). Multivariate analysis showed no significant effect of the used storage medium on the incidence of 1- and 24-hour transfusion failure. We showed safety and efficacy of PAS II PCs in intensively treated patients; however, plasma PCs show superior increments.

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Prevalence of Platelet Transfusion Reactions Before and After Implementation of Leukocyte-Depleted Platelet Concentrates by Filtration

Vox Sanguinis ◽

10.1159/000462396 ◽

1993 ◽

Vol 65 (2) ◽

pp. 103-107 ◽

Cited By ~ 2

Author(s):

Lawrence Tim Goodnough ◽

James Riddell ◽

Hillard Lazarus ◽

Theresa L. Chafel ◽

Greg Prince ◽

...

Keyword(s):

Platelet Transfusion ◽

Platelet Concentrates ◽

Before And After ◽

Transfusion Reactions

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Correction of poor platelet transfusion responses with leukocyte-poor HL-A-matched platelet concentrates

Blood ◽

10.1182/blood.v46.5.743.743 ◽

1975 ◽

Vol 46 (5) ◽

pp. 743-750 ◽

Cited By ~ 73

Author(s):

RH Herzig ◽

GP Herzig ◽

MI Bull ◽

JA Decter ◽

HP Lohrmann ◽

...

Keyword(s):

Blood Cells ◽

Platelet Transfusion ◽

White Blood Cells ◽

Innocent Bystander ◽

Platelet Concentrates ◽

Simple Method ◽

The Poor ◽

Starting Point ◽

Antigen Antibody ◽

Transfusion Reactions

Abstract Matching donor-recipient pairs for HL-A antigens provides a logical starting point for selecting donors for recipients with extensive prior transfusion histories. However, during the course of continued exposure to even HL-A-matched platelet concentrates, further sensitization occurs, as indicated by progressively poorer post-transfusion increments and transfusion reactions. There is evidence that such sensitization may be due to non-HL-A antigens. Finally, it is postulated that the poor post-transfusion platelet increments obtained when standard platelet concentrates are used result from the leukoagglutinin antigen-antibody reaction involving the platelet as an “innocent bystander.” The standard platelet concentrate can be purified by a simple method of centrifugation (178 g times 3 min), removing about 96% of the contaminating white blood cells with concomitant loss of about 21% of the platelets. The use of these leukocyte-poor platelet concentrates can restore compatible transfusion increments in highly alloimmunized thrombocytopenic recipients. The luekocyte-poor concentrates can diminish undesirable transfusion reactions following imcompatible platelet transfusions.

Download Full-text