Use of additive solutions and pathogen inactivation treatment of platelet components in a regional blood center: impact on patient outcomes and component utilization during a 3-year period.
BACKGROUND
The Etablissement Français du Sang Alsace (EFS Alsace) successively implemented universal use of platelet additive solutions (PASs) and pathogen inactivation (PI) for platelet components (PCs). To assess the impact of these changes, EFS Alsace evaluated PC use, red blood cell (RBC) component use, and transfusion-related adverse events after implementation of these new technologies.


METHODS
EFS Alsace prospectively collects data on production, distribution, and response to transfusion of all blood components with greater than 99.5% data acquisition. Adverse events attributed to platelet (PLT) transfusions were collected through a mandatory, active hemovigilance program. A retrospective review of prospectively collected data was conducted covering three periods: 1) apheresis and whole blood-derived PCs in plasma, 2) apheresis and whole blood-derived PCs with PAS, and 3) PCs prepared with PI and PAS. Data on component utilization were analyzed for all patients receiving PCs in each period and for the subset of hematology-oncology patients to evaluate PC use in an intensely transfused population. Values for all continuous variables were summarized as mean and standard deviation, median, and range.


RESULTS
Approximately 2000 patients received PCs in each period. PLT and RBC use per patient was not increased after PI (analysis of variance, F = 1.9 and 2.9, respectively) and the incidence of acute transfusion reactions was significantly reduced (p < 0.001).


CONCLUSIONS
Universal use of PI was implemented without impacting component use, as indicated by total dose of PLTs per patient, and outcomes to transfusion were improved.
Cazenave
Jean-Pierre
JP
Etablissement Français du Sang-Alsace, INSERM UMR-S949, and the Université de Strasbourg, Strasbourg, France. jeanpierre.cazenave@efsalsace.fr
Isola
Hervé
H
Waller
Chantal
C
Mendel
Isabelle
I
Kientz
Daniel
D
Laforêt
Michel
M
Raidot
Jean-Pierre
JP
Kandel
Gérard
G
Wiesel
Marie-Louise
ML
Corash
Laurence
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000382:microbiology*; D017848:Blood-Borne Pathogens / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D004203:Disinfection; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects / Q000379:methods