Transfusion reactions after transfusion of platelets stored in PAS-B, PAS-C, or plasma: a nationwide comparison

Abstract

BACKGROUND: Platelets (PLTs) stored in PLT additivesolution (PAS) are associated with fewer allergicreactions than plasma-stored PLTs. However, earlierstudies could not provide conclusive evidence on febrilereactions and did not analyze other transfusion reactionsseparately due to limited sample size. We thereforecompared incidences of all transfusion reactions of PAS-B-PLTs, PAS-C-PLTs, and plasma-PLTs.STUDY DESIGN AND METHODS: In thisobservational study, all transfusion reactions reported tothe national hemovigilance office of the Netherlands from2006 to 2015 were included.RESULTS: During the study period, a total of 2407transfusion reactions after PLT transfusions werereported. In that period 553,267 pooled buffy coat–derived PLT units were issued, of which 83,884 werestored in PAS-B, 45,728 in PAS-C, and 423,655 inplasma. Regarding transfusion-related circulatoryoverload, transfusion-related acute lung injury, and “otherreactions” no significant differences were observedbetween the PLT products. When PAS-B-PLTtransfusions were compared to plasma-PLT transfusions,the overall relative risk (RR; 95% confidence interval [CI])of transfusion reactions was 0.99 (0.88-1.11); for allergicand febrile nonhemolytic transfusion reactions (FNHTRs)it was 0.66 (0.55-0.80) and 1.54 (1.27-1.86), respectively.When PAS-C-PLTs were compared to plasma-PLTs, theRR (95% CI) was 0.56 (0.46-0.68) for all transfusionreactions, 0.38 (0.28-0.52) for allergic reactions, and0.82 (0.59-1.13) for FNHTRs. When PAS-C-PLTs werecompared to PAS-B-PLTs, for all reactions the RR (95%CI) was 0.56 (0.45-0.70) for allergic reactions 0.58 (0.40-0.82), and for FNHTRs 0.53 (0.37-0.75).CONCLUSIONS: PAS-C-PLTs are associated withfewer transfusion reactions compared to plasma-PLTsand compared to PAS-B-PLTs.