Blood Utilization and Transfusion Reactions in Pediatric Patients Transfused with Conventional or Pathogen Reduced Platelets

To assess the safety and efficacy of a Food and Drug Administration-approved pathogen-reduced platelet (PLT) product in children, as ongoing questions regarding their use in this population remain. We report findings from a quality assurance review of PLT utilization, associated red blood cell trans...

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Bibliographic Details
Published in:The Journal of pediatrics Vol. 209; pp. 220 - 225
Main Authors: Schulz, Wade L., McPadden, Jacob, Gehrie, Eric A., Bahar, Burak, Gokhale, Amit, Ross, Rebecca, Price, Nathaniel, Spencer, Bryan R., Snyder, Edward
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.06.2019
Subjects:
Adolescent
Bacterial Infections - prevention & control
Child
Child, Preschool
Humans
Infant
Infant, Newborn
Infection Control
pathogen reduction
pediatric transfusion
Platelet Transfusion - adverse effects
Platelet Transfusion - statistics & numerical data
Procedures and Techniques Utilization - statistics & numerical data
Transfusion Reaction - epidemiology
transfusion safety
Virus Diseases - prevention & control
INF
transfusion safety
UV
CCI
pediatric transfusion
NICU
PLT
PED
pathogen reduction
ISSN:0022-3476, 1097-6833, 1097-6833
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Summary:To assess the safety and efficacy of a Food and Drug Administration-approved pathogen-reduced platelet (PLT) product in children, as ongoing questions regarding their use in this population remain. We report findings from a quality assurance review of PLT utilization, associated red blood cell transfusion trends, and short-term safety of conventional vs pathogen-reduced PLTs over a 21-month period while transitioning from conventional to pathogen-reduced PLTs at a large, tertiary care hospital. We assessed utilization in neonatal intensive care unit (NICU) patients, infants 0-1 year not in the NICU, and children age 1-18 years (PED). In the 48 hours after an index conventional or pathogen-reduced platelet transfusion, respectively, NICU patients received 1.0 ± 1.4 (n = 91 transfusions) compared with 1.2 ± 1.3 (n = 145) additional platelet doses (P = .29); infants 0-1 year not in the NICU received 2.8 ± 3.0 (n = 125) vs 2.6 ± 2.6 (n = 254) additional platelet doses (P = .57); and PEDs received 0.9 ± 1.6 (n = 644) vs 1.4 ± 2.2 (n = 673) additional doses (P < .001). Time to subsequent transfusion and red cell utilization were similar in every group (P > .05). The number and type of transfusion reactions did not significantly vary based on PLT type and no rashes were reported in NICU patients receiving phototherapy and pathogen-reduced PLTs. Conventional and pathogen-reduced PLTs had similar utilization patterns in our pediatric populations. A small, but statistically significant, increase in transfusions was noted following pathogen-reduced PLT transfusion in PED patients, but not in other groups. Red cell utilization and transfusion reactions were similar for both products in all age groups.
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ISSN:0022-3476
1097-6833
1097-6833
DOI:10.1016/j.jpeds.2019.01.046