title: Apheresis platelets are more frequently associated with adverse reactions than pooled platelets both in recipients and in donors: a study from French hemovigilance data.
abstract: Controversy exists regarding the safety of the different types of platelet (PLT) concentrates. This study was aimed at comparing the rate of adverse reactions associated with apheresis PLT concentrates (APCs) and pooled PLT concentrates (PPCs) both in donors and in recipients.
  
  
  
  From the French national hemovigilance system, types and numbers of recipient adverse reactions were compared over a period from 2009 to 2011. Donor adverse reactions were available for 2010 and 2011. This study involved 23 of 26 French regions. Main outcomes were the rates of adverse reaction in recipients and serious adverse reaction in donors.
  
  
  
  There were 790,854 PLT transfusions during the study period (477,747 [60%] with APCs, 313,107 [40%] with PPCs). APCs were associated with more adverse reactions (6244 vs. 2469 per 1,000,000, p < 0.001) and more severe and life-threatening reactions (respectively, 241 vs. 131 per 1,000,000, p < 0.001; and 182 vs. 121 per 1,000,000, p = 0.04). Mortality rates due to an adverse transfusion reaction were similar (15 vs. 6 per 1,000,000, p = 0.5). In donors, the number of whole blood (WB) donations was 4,722,685 whereas 266,095 apheresis procedures were performed. Serious adverse reactions were more frequent for apheresis procedures than for WB donations (5445 vs. 803 per 1,000,000, p < 0.001).
  
  
  
  Our findings suggest that apheresis PLTs may be more hazardous than pooled PLTs both in recipients and in donors. This study calls for randomized trials to confirm or refute these results.
authors.affiliation: Division Anesthésie Réanimation, Urgences Douleur, Centre Hospitalier Universitaire de Nîmes, Nîmes, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Daurat
authors.affiliation: Division Anesthésie Réanimation, Urgences Douleur, Centre Hospitalier Universitaire de Nîmes, Nîmes, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Roger
authors.affiliation: Laboratory of Hematology, Centre Hospitalier Universitaire de Nîmes, Nîmes, France.
authors.forename: JeanChristophe
authors.initials: J
authors.lastname: Gris
authors.affiliation: Délégation Qualité Gestion des Risques, Centre Hospitalier Universitaire de Nîmes, Nîmes, France.
authors.forename: Gérald
authors.initials: G
authors.lastname: Daurat
authors.affiliation: Etablissement Français du Sang Pyrénées-Méditerranée, Nîmes, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Feissel
authors.affiliation: Departments of Anesthesia & Clinical Epidemiology and Biostatistics, Michael DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Le Manach
authors.affiliation: Division Anesthésie Réanimation, Urgences Douleur, Centre Hospitalier Universitaire de Nîmes, Nîmes, France.
authors.forename: JeanYves
authors.initials: J
authors.lastname: Lefrant
authors.affiliation: Division Anesthésie Réanimation, Urgences Douleur, Centre Hospitalier Universitaire de Nîmes, Nîmes, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Muller
mesh_terms: D001782:Blood Donors; D001792:Blood Platelets / Q000166:cytology*; D058731:Blood Safety; D062665:Epidemiological Monitoring; D005602:France / Q000453:epidemiology; D006801:Humans; D017713:Platelet Transfusion / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010983:Plateletpheresis / Q000009:adverse effects*