title: Patient outcomes and amotosalen/UVA-treated platelet utilization in massively transfused patients.
abstract: BACKGROUND
  Amotosalen/UVA-treated platelet concentrates (PCs) have demonstrated efficacy for treating and preventing bleeding in clinical trials and in routine use; however, most studies were performed in haematology/oncology patients. We investigated efficacy during massive transfusion (MT) in general hospitalized patients.
  
  
  METHODS
  Universal amotosalen/UVA treatment (INTERCEPT Blood System) of platelets was introduced at a large Austrian medical centre. We performed a retrospective cohort analysis comparing component use, in-hospital mortality and length of stay after MT that included platelet transfusion, for two periods (21 months each) before and after implementation.
  
  
  RESULTS
  A total of 306 patients had MT. Patients were mostly male (74%) and ≥18 years old (99%), including 93 liver transplant, 97 cardiac or vascular surgery and 51 trauma patients. There were no differences in demographics between the periods. Component use on the day and within 7 days of the MT event was unchanged post-IBS implementation, except trauma patients received fewer RBCs on the day. The mean ratio of RBC:platelets:plasma on the day of the MT was close to 1:1:1 in both periods, except for liver transplants with MT who received more plasma components. Overall, in-hospital mortality (preimplementation = 27·6% vs. postimplementation = 24·0%; P = 0·51) and median time to discharge (preimplementation = 27 vs. postimplementation = 23 days; P = 0·37) did not change, except for cardiac and vascular surgery patients who were discharged earlier.
  
  
  CONCLUSIONS
  The introduction of amotosalen/UVA-treated, pathogen-reduced PC did not adversely affect clinical outcomes in massively transfused patients in terms of blood product usage, in-hospital mortality and length of stay for a range of clinical indications for platelet transfusion support.
authors.affiliation: Central Institute for Blood Transfusion and Immunology, Medical University Hospital Innsbruck, Innsbruck, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Nussbaumer
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: L
authors.initials: L
authors.lastname: Corash
authors.affiliation: Cerus Corporation, Concord, CA, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Benjamin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001317:Austria; D001792:Blood Platelets / Q000187:drug effects* / Q000378:metabolism / Q000528:radiation effects; D002318:Cardiovascular Diseases / Q000401:mortality / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D011564:Furocoumarins / Q000494:pharmacology*; D017052:Hospital Mortality; D006761:Hospitals; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008107:Liver Diseases / Q000401:mortality / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion; D012189:Retrospective Studies; D016896:Treatment Outcome; D014466:Ultraviolet Rays; D014947:Wounds and Injuries / Q000401:mortality / Q000473:pathology; D055815:Young Adult
chemical_list: D011564:Furocoumarins; C118577:amotosalen
keywords: INTERCEPT Blood System; amotosalen; massive transfusion; pathogen reduction; platelets