title: Improving platelet transfusion safety: biomedical and technical considerations.
abstract: Platelet concentrates account for near 10% of all labile blood components but are responsible for more than 25% of the reported adverse events. Besides factors related to patients themselves, who may be particularly at risk of side effects because of their underlying illness, there are aspects of platelet collection and storage that predispose to adverse events. Platelets for transfusion are strongly activated by collection through disposal equipment, which can stress the cells, and by preservation at 22 °C with rotation or rocking, which likewise leads to platelet activation, perhaps more so than storage at 4 °C. Lastly, platelets constitutively possess a very large number of bioactive components that may elicit pro-inflammatory reactions when infused into a patient. This review aims to describe approaches that may be crucial to minimising side effects while optimising safety and quality. We suggest that platelet transfusion is complex, in part because of the complexity of the "material" itself: platelets are highly versatile cells and the transfusion process adds a myriad of variables that present many challenges for preserving basal platelet function and preventing dysfunctional activation of the platelets. The review also presents information showing--after years of exhaustive haemovigilance--that whole blood buffy coat pooled platelet components are extremely safe compared to the gold standard (i.e. apheresis platelet components), both in terms of acquired infections and of immunological/inflammatory hazards.
authors.affiliation: National Institute of Blood Transfusion (INTS), Paris, France.|GIMAP-EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Garraud
authors.affiliation: GIMAP-EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France.|Auvergne-Loire Blood Establishment, Saint-Etienne, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Cognasse
authors.affiliation: Blood Transfusion Service of the Swiss Red Cross, Epalinges, Switzerland.
authors.forename: Jean-Daniel
authors.initials: JD
authors.lastname: Tissot
authors.affiliation: Auvergne-Loire Blood Establishment, Saint-Etienne, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: Chavarin
authors.affiliation: National Institute of Blood Transfusion (INTS), Paris, France.
authors.forename: Syria
authors.initials: S
authors.lastname: Laperche
authors.affiliation: Bourgogne Franche-Comté Blood Establishment, Besançon, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Morel
authors.affiliation: National Institute of Blood Transfusion (INTS), Paris, France.|Paris Descartes University, Paris, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Lefrère
authors.affiliation: GIMAP-EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pozzetto
authors.affiliation: Department of Hemotherapy and Hemostasis, University Clinic Hospital, Barcelona, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Lozano
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States of America.
authors.forename: Neil
authors.initials: N
authors.lastname: Blumberg
authors.affiliation: Blood Transfusion Service of the Swiss Red Cross, Epalinges, Switzerland.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Osselaer
mesh_terms: D001793:Blood Preservation / Q000379:methods*; D058731:Blood Safety / Q000379:methods*; D006801:Humans; D017713:Platelet Transfusion / Q000379:methods*