title: Impact of platelet pathogen inactivation on blood component utilization and patient safety in a large Austrian Regional Medical Centre.
abstract: BACKGROUND
  In clinical studies, pathogen inactivation (PI) of platelet concentrates (PC) with amotosalen and UVA light did not impact patient risk for haemorrhage but may affect transfusion frequency and component utilization. We evaluated the influence of platelet PI on PC, red cell concentrate (RCC) and plasma use and safety in routine practice in a large regional hospital.
  
  
  METHODS
  Comparative effectiveness of conventional vs. PI-treated PC was analysed during two 21-month periods, before and after PI implementation.
  
  
  RESULTS
  Similar numbers of patients were transfused in the pre-PI (control, 1797) and post-PI (test, 1694) periods with comparable numbers of PC (8611 and 7705, respectively). The mean numbers of PC per patient transfused (4·8 vs. 4·5, P = 0·43) were not different but days of PC support (5·9 vs. 5·0, P < 0·01) decreased. Most patients received RCC (86·8% control vs. 84·8% test, P = 0·90) with similar mean numbers transfused (10·8 vs. 10·2 RCC, P = 0·22), and fewer patients (55·4% control vs. 44·7% test, P < 0·01) received less plasma units (mean 9·9 vs. 7·8, respectively, P < 0·01) in the test period. The frequencies of transfusion-related adverse events (AE) were comparable (1·3% vs. 1·4%, P = 0·95). Analysis of haematology-oncology (522 control, 452 test), cardiac surgery (739 control, 711 test), paediatric (157 control, 130 test) and neonate (23 control, 20 test) patients revealed no increase in PC, plasma and RCC utilization, or AE.
  
  
  CONCLUSIONS
  Component utilization and patient safety were not impacted by adoption of PI for PC. RCC use per patient was comparable, suggestive of no increase in significant bleeding.
authors.affiliation: Central Institute for Blood Transfusion and Immunology, Medical University Hospital Innsbruck, Innsbruck, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Amato
authors.affiliation: Central Institute for Blood Transfusion and Immunology, Medical University Hospital Innsbruck, Innsbruck, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Schennach
authors.affiliation: Central Institute for Blood Transfusion and Immunology, Medical University Hospital Innsbruck, Innsbruck, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Astl
authors.affiliation: Cerus Corporation, Concord, CA, USA.
authors.forename: C Y
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Cerus Corporation, Concord, CA, USA.
authors.forename: J-S
authors.initials: JS
authors.lastname: Lin
authors.affiliation: Cerus Corporation, Concord, CA, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Benjamin
authors.affiliation: Central Institute for Blood Transfusion and Immunology, Medical University Hospital Innsbruck, Innsbruck, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Nussbaumer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D016913:Blood Component Transfusion / Q000009:adverse effects*; D001792:Blood Platelets / Q000166:cytology* / Q000187:drug effects / Q000528:radiation effects; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D005260:Female; D011564:Furocoumarins / Q000494:pharmacology; D006761:Hospitals; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects; D013997:Time Factors; D014466:Ultraviolet Rays; D038301:Virus Inactivation / Q000187:drug effects / Q000528:radiation effects; D055815:Young Adult
chemical_list: D011564:Furocoumarins; C118577:amotosalen
keywords: INTERCEPT Blood System; amotosalen; haemovigilance; pathogen inactivation; platelets; safety