Blood Utilization and Transfusion Reactions in Pediatric Patients Transfused with Conventional or Pathogen Reduced Platelets

Abstract

To assess the safety and efficacy of a Food and Drug Administration-approved pathogen-reduced platelet (PLT) product in children, as ongoing questions regarding their use in this population remain. We report findings from a quality assurance review of PLT utilization, associated red blood cell transfusion trends, and short-term safety of conventional vs pathogen-reduced PLTs over a 21-month period while transitioning from conventional to pathogen-reduced PLTs at a large, tertiary care hospital. We assessed utilization in neonatal intensive care unit (NICU) patients, infants 0-1year not in the NICU, and children age 1-18years (PED). In the 48hours after an index conventional or pathogen-reduced platelet transfusion, respectively, NICU patients received 1.0±1.4 (n=91 transfusions) compared with 1.2±1.3 (n=145) additional platelet doses (P=.29); infants 0-1year not in the NICU received 2.8±3.0 (n=125) vs 2.6±2.6 (n=254) additional platelet doses (P=.57); and PEDs received 0.9±1.6 (n=644) vs 1.4±2.2 (n=673) additional doses (P< .001). Time to subsequent transfusion and red cell utilization were similar in every group (P> .05). The number and type of transfusion reactions did not significantly vary based on PLT type and no rashes were reported in NICU patients receiving phototherapy and pathogen-reduced PLTs. Conventional and pathogen-reduced PLTs had similar utilization patterns in our pediatric populations. A small, but statistically significant, increase in transfusions was noted following pathogen-reduced PLT transfusion in PED patients, but not in other groups. Red cell utilization and transfusion reactions were similar for both products in all age groups.