A randomized study of buffy coat platelets in platelet additive solution stored 1-5 versus 6-7 days prior to prophylactic transfusion of allogeneic haematopoietic progenitor cell transplant recipients.
OBJECTIVE
Storage of platelets > 5 days provides improved availability, logistical management and decreased outdating. Promising results on in vitro parameters and on in vivo post-transfusion recovery and survival of autologous platelets in healthy volunteers have earlier been shown. To provide additional verification, randomized patient transfusion studies are needed.


METHODS
Sixty allogeneic haematopoietic progenitor cell transplant recipients were randomized to receive buffy-coat (BC) platelets stored in platelet additive solution (PAS) for 1-5 days the first time a prophylactic transfusion was needed after transplantation, followed the second time by platelets stored for 6-7 days or vice versa. The corrected count increment (CCI) for 1 and 24 h were calculated.


RESULTS
CCI 1 h and CCI 24 h were higher for platelets stored 1-5 days as compared to 6-7 days, 10.4 +/- 5.1 vs. 7.4 +/- 3.8 (P < 0.001) and 5.4 +/- 4.1 vs. 2.6 +/- 2.6 (P < 0.001), respectively. Time to next platelet transfusion was significantly longer after a transfusion of platelets stored for 1-5 days as compared to platelets stored for 6-7 days: 2.2 +/- 1.1 vs. 1.6 +/- 0.8 days, respectively (P < 0.005). No differences in bleeding events and no transfusion reaction were recorded.


CONCLUSIONS
The advantage of an extension of platelet storage time beyond day 5 should be balanced against the increased need for platelet transfusions that may occur and the conceivable risk of transfusion failure.
Diedrich
B
B
Departments of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden. beatrice.diedrich@karolinska.se
Ringdén
O
O
Watz
E
E
Shanwell
A
A
D000293:Adolescent; D000328:Adult; D001792:Blood Platelets / Q000187:drug effects*; D001793:Blood Preservation / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000601:surgery; D019999:Pharmaceutical Solutions / Q000494:pharmacology*; D017713:Platelet Transfusion / Q000379:methods; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy*; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013921:Thrombocytopenia / Q000150:complications / Q000628:therapy*; D013997:Time Factors; D014184:Transplantation, Homologous; D055815:Young Adult
D019999:Pharmaceutical Solutions