title: Febrile reactions after platelet transfusion: the effect of single versus multiple donors.
abstract: Febrile reactions to platelet transfusions are a common problem. The platelet transfusion records from a 30-month period were analyzed to determine 1) when reactions occur in a transfusion sequence; 2) how frequently they recur; and 3) whether the choice of multiple-donor (pooled concentrates) or single-donor components (unmatched apheresis and HLA-compatible apheresis platelets) affected the reaction rate. Overall, 18.7 percent of all patients receiving platelets experienced reactions. A subset of 85 patients, who began platelet support with unmodified components during the study interval, were analyzed in detail. This group received 1204 unmodified transfusions (mean, 14.2/patient), which were associated with 171 reactions (per-transfusion reaction rate, 14.2%). Despite a higher mean white cell content, the transfusion of 438 unmatched single-donor platelets (10.84 x 10(8) white cells, 8.4% reaction rate) resulted in reactions significantly less often than did that of 583 pooled concentrates (8.53 x 10(8) white cells, 21.4% reaction rate) (p less than 0.001). The rate of reaction to HLA-compatible platelets (9/183 transfusions, 4.9%) was not significantly different from that to unmatched single-donor platelets. The use of platelet components from one donor, as opposed to multiple donors, may provide an effective means of reducing the incidence of febrile reactions.
authors.affiliation: Department of Pathology, Charles A. Dana Research Institute, Boston, Massachusetts.
authors.forename: L A
authors.initials: LA
authors.lastname: Chambers
authors.forename: M S
authors.initials: MS
authors.lastname: Kruskall
authors.forename: D G
authors.initials: DG
authors.lastname: Pacini
authors.forename: L M
authors.initials: LM
authors.lastname: Donovan
mesh_terms: D001782:Blood Donors; D005334:Fever / Q000209:etiology*; D006801:Humans; D007958:Leukocyte Count; D017713:Platelet Transfusion / Q000009:adverse effects*; D010983:Plateletpheresis; D065227:Transfusion Reaction