The relationship between the duration of platelet storage and the development of transfusion reactions.
BACKGROUND
The incidence of platelet transfusion reactions may depend partly on the length of storage. The influence of reactions on the effectiveness of platelet transfusions is not known.


METHODS
Platelet transfusion reactions, identified by prospective monitoring, were analyzed for the effects of component type, recipient lymphocytotoxic antibodies, bacterial contamination, and duration of storage. Posttransfusion corrected count increments (CCIs) were used to evaluate the effectiveness of transfusions associated with reactions by comparing them to those of randomly selected transfusions without reactions.


RESULTS
Reactions accompanied 4 percent of the 4926 transfusions given and included 119 febrile nonhemolytic transfusion reactions, 62 allergic reactions, and 13 reactions with features of both. Platelet concentrates contained a mean of 0.5 x 10(8) white cells per unit. Lymphocytotoxic antibodies were detectable in 20 of 84 recipients tested proximate to a reaction. Bacterial cultures from 4 of 81 units were positive; 1 unit was associated with fatal Enterobacter sp. sepsis. The incidence of febrile nonhemolytic transfusion reactions but not allergic reactions was related to platelet storage duration. The CCI was not significantly different for transfusions associated with reactions (10.97 [median, range 0-72.5; n = 165]) or not so associated (13.1 [median, range 0-39.5; n = 174]) (p = 0.08).


CONCLUSIONS
The incidence of febrile nonhemolytic transfusion reactions but not allergic reactions appears to be related to the duration of platelet storage. Transfusion reactions may not have an adverse impact on the effectiveness of platelet transfusions.
Sarkodee-Adoo
C B
CB
Department of Medicine, Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore 21201, USA.
Kendall
J M
JM
Sridhara
R
R
Lee
E J
EJ
Schiffer
C A
CA
D000208:Acute Disease; D000961:Antilymphocyte Serum / Q000276:immunology; D001424:Bacterial Infections / Q000209:etiology; D001793:Blood Preservation; D005260:Female; D005334:Fever; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology; D008297:Male; D010976:Platelet Count; D017713:Platelet Transfusion / Q000009:adverse effects* / Q000379:methods; D011446:Prospective Studies; D013997:Time Factors
D000961:Antilymphocyte Serum