title: The utility of < or =3-day-old whole-blood platelets in reducing the incidence of febrile nonhemolytic transfusion reactions.
abstract: BACKGROUND
  Febrile nonhemolytic transfusion reactions (FNHTRs) to platelet transfusions have been linked to the presence of cytokines in supernatant plasma. Cytokine concentration is directly related to WBC content and storage time. This study evaluated the effect of limiting the storage time of random-donor platelet concentrates on the FNHTR rate.
  
  
  METHODS
  FNHTR rates were calculated retrospectively for single-donor apheresis platelet (SDP) and pooled random-donor platelet (PP) transfusions given during three consecutive 5-month study periods (November 1995 to February 1997) to patients on a single hematology/oncology/bone marrow transplant unit. Transfusion practice policies were: Baseline Period, SDPs preferred; Study Period A, PPs preferred; and Study Period B, < or =3-day-old PPs preferred. FNHTR rates were calculated from physicians' interpretations of reported reactions and the total number of SDP and PP transfusions in each period. SDPs were collected on two cell separators. All platelet components were filtered at issue in the laboratory by WBC-reduction filters.
  
  
  RESULTS
  FNHTR rates for PP transfusions were: baseline, 11.1 percent (3/27); Study Period A, 4.6 percent (22/481); and Study Period B, 1.1 percent (3/282). The rates for SDP transfusions were 0. 15 percent (1/650), 0.75 percent (2/267), and 0.36 percent (1/273), respectively. The FNHTR rate for < or =3-day-old PPs was significantly less than the rate for older PPs (p = 0.0086 for Study Period A vs. Study Period B), and was not significantly different than that for SDPs (p = 0.33 for PPs vs. SDPs in Study Period B).
  
  
  CONCLUSIONS
  Limiting transfusion of PPs to those stored </=3 days is an effective strategy in reducing the rate of FNHTR and results in an FNHTR rate comparable to that seen with SDPs.
authors.affiliation: Institute for Transfusion Medicine, Pittsburgh, PA 15213, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Kelley
authors.forename: J
authors.initials: J
authors.lastname: Mangini
authors.forename: I
authors.initials: I
authors.lastname: Lopez-Plaza
authors.forename: D J
authors.initials: DJ
authors.lastname: Triulzi
mesh_terms: D001792:Blood Platelets / Q000737:chemistry; D001793:Blood Preservation; D016207:Cytokines / Q000502:physiology; D005334:Fever / Q000209:etiology*; D006461:Hemolysis / Q000502:physiology*; D006801:Humans; D013997:Time Factors; D065227:Transfusion Reaction
chemical_list: D016207:Cytokines