Platelet storage duration and its clinical and transfusion outcomes

A systematic review

Research output: Contribution to journalReview ArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Background: Platelets (PLTs) are usually stored for up to 5days prior to transfusion, although in some blood services the storage period is extended to 7days. During storage, changes occur in both PLT and storage medium, which may lead to PLT activation and dysfunction. The clinical significance of these changes remains uncertain. Methods: We performed a systematic review to assess the association between PLT storage time and clinical or transfusion outcomes in patients receiving allogeneic PLT transfusion. We searched studies published in English between January 2000 and July 2017 identified from MEDLINE, Embase, PubMed and the Cochrane Libraries. Results: Of the 18 studies identified, five included 4719 critically ill patients (trauma, post-cardiac surgery and a heterogeneous population of critically ill patients) and 13 included 8569 haematology patients. The five studies in critically ill patients were retrospective and did not find any association between PLT storage time when PLTs were stored for up to 5days and mortality. There was also no association between older PLTs and sepsis in the two largest studies (n=4008 patients). Of the 13 studies in haematology patients, seven analysed prolonged storage time up to 6.5 or 7days. Administration of fresh PLTs (less than 2 or 3days) was associated with a significant increase in corrected count increment (CCI) compared to older PLTs in seven of the eight studies analysing this outcome. One single centre retrospective study found an increase in bleeding events in patients receiving older PLTs. Conclusions: PLT storage time does not appear to be associated with clinical outcomes, including bleeding, sepsis or mortality, in critically ill patients or haematology patients. The freshest PLTs (less than 3days) were associated with a better CCI, although there was no impact on bleeding events, questioning the clinical significance of this association. However, there is an absence of evidence to draw definitive conclusions, especially in critically ill patients.

Original languageEnglish
Article number185
Number of pages13
JournalCritical Care
Volume22
Issue number1
DOIs
Publication statusPublished - 5 Aug 2018

Keywords

  • Allogeneic transfusion
  • Complication
  • Critically ill patients
  • Efficacy
  • Haematology patients
  • Platelet storage

Cite this

@article{bf90215f9c564b8fa73317392f8a54e7,
title = "Platelet storage duration and its clinical and transfusion outcomes: A systematic review",
abstract = "Background: Platelets (PLTs) are usually stored for up to 5days prior to transfusion, although in some blood services the storage period is extended to 7days. During storage, changes occur in both PLT and storage medium, which may lead to PLT activation and dysfunction. The clinical significance of these changes remains uncertain. Methods: We performed a systematic review to assess the association between PLT storage time and clinical or transfusion outcomes in patients receiving allogeneic PLT transfusion. We searched studies published in English between January 2000 and July 2017 identified from MEDLINE, Embase, PubMed and the Cochrane Libraries. Results: Of the 18 studies identified, five included 4719 critically ill patients (trauma, post-cardiac surgery and a heterogeneous population of critically ill patients) and 13 included 8569 haematology patients. The five studies in critically ill patients were retrospective and did not find any association between PLT storage time when PLTs were stored for up to 5days and mortality. There was also no association between older PLTs and sepsis in the two largest studies (n=4008 patients). Of the 13 studies in haematology patients, seven analysed prolonged storage time up to 6.5 or 7days. Administration of fresh PLTs (less than 2 or 3days) was associated with a significant increase in corrected count increment (CCI) compared to older PLTs in seven of the eight studies analysing this outcome. One single centre retrospective study found an increase in bleeding events in patients receiving older PLTs. Conclusions: PLT storage time does not appear to be associated with clinical outcomes, including bleeding, sepsis or mortality, in critically ill patients or haematology patients. The freshest PLTs (less than 3days) were associated with a better CCI, although there was no impact on bleeding events, questioning the clinical significance of this association. However, there is an absence of evidence to draw definitive conclusions, especially in critically ill patients.",
keywords = "Allogeneic transfusion, Complication, Critically ill patients, Efficacy, Haematology patients, Platelet storage",
author = "C{\'e}cile Aubron and Flint, {Andrew W.J.} and Yves Ozier and Zoe McQuilten",
year = "2018",
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Platelet storage duration and its clinical and transfusion outcomes : A systematic review. / Aubron, Cécile; Flint, Andrew W.J.; Ozier, Yves; McQuilten, Zoe.

In: Critical Care, Vol. 22, No. 1, 185, 05.08.2018.

Research output: Contribution to journalReview ArticleResearchpeer-review

TY - JOUR

T1 - Platelet storage duration and its clinical and transfusion outcomes

T2 - A systematic review

AU - Aubron, Cécile

AU - Flint, Andrew W.J.

AU - Ozier, Yves

AU - McQuilten, Zoe

PY - 2018/8/5

Y1 - 2018/8/5

N2 - Background: Platelets (PLTs) are usually stored for up to 5days prior to transfusion, although in some blood services the storage period is extended to 7days. During storage, changes occur in both PLT and storage medium, which may lead to PLT activation and dysfunction. The clinical significance of these changes remains uncertain. Methods: We performed a systematic review to assess the association between PLT storage time and clinical or transfusion outcomes in patients receiving allogeneic PLT transfusion. We searched studies published in English between January 2000 and July 2017 identified from MEDLINE, Embase, PubMed and the Cochrane Libraries. Results: Of the 18 studies identified, five included 4719 critically ill patients (trauma, post-cardiac surgery and a heterogeneous population of critically ill patients) and 13 included 8569 haematology patients. The five studies in critically ill patients were retrospective and did not find any association between PLT storage time when PLTs were stored for up to 5days and mortality. There was also no association between older PLTs and sepsis in the two largest studies (n=4008 patients). Of the 13 studies in haematology patients, seven analysed prolonged storage time up to 6.5 or 7days. Administration of fresh PLTs (less than 2 or 3days) was associated with a significant increase in corrected count increment (CCI) compared to older PLTs in seven of the eight studies analysing this outcome. One single centre retrospective study found an increase in bleeding events in patients receiving older PLTs. Conclusions: PLT storage time does not appear to be associated with clinical outcomes, including bleeding, sepsis or mortality, in critically ill patients or haematology patients. The freshest PLTs (less than 3days) were associated with a better CCI, although there was no impact on bleeding events, questioning the clinical significance of this association. However, there is an absence of evidence to draw definitive conclusions, especially in critically ill patients.

AB - Background: Platelets (PLTs) are usually stored for up to 5days prior to transfusion, although in some blood services the storage period is extended to 7days. During storage, changes occur in both PLT and storage medium, which may lead to PLT activation and dysfunction. The clinical significance of these changes remains uncertain. Methods: We performed a systematic review to assess the association between PLT storage time and clinical or transfusion outcomes in patients receiving allogeneic PLT transfusion. We searched studies published in English between January 2000 and July 2017 identified from MEDLINE, Embase, PubMed and the Cochrane Libraries. Results: Of the 18 studies identified, five included 4719 critically ill patients (trauma, post-cardiac surgery and a heterogeneous population of critically ill patients) and 13 included 8569 haematology patients. The five studies in critically ill patients were retrospective and did not find any association between PLT storage time when PLTs were stored for up to 5days and mortality. There was also no association between older PLTs and sepsis in the two largest studies (n=4008 patients). Of the 13 studies in haematology patients, seven analysed prolonged storage time up to 6.5 or 7days. Administration of fresh PLTs (less than 2 or 3days) was associated with a significant increase in corrected count increment (CCI) compared to older PLTs in seven of the eight studies analysing this outcome. One single centre retrospective study found an increase in bleeding events in patients receiving older PLTs. Conclusions: PLT storage time does not appear to be associated with clinical outcomes, including bleeding, sepsis or mortality, in critically ill patients or haematology patients. The freshest PLTs (less than 3days) were associated with a better CCI, although there was no impact on bleeding events, questioning the clinical significance of this association. However, there is an absence of evidence to draw definitive conclusions, especially in critically ill patients.

KW - Allogeneic transfusion

KW - Complication

KW - Critically ill patients

KW - Efficacy

KW - Haematology patients

KW - Platelet storage

UR - http://www.scopus.com/inward/record.url?scp=85051088998&partnerID=8YFLogxK

U2 - 10.1186/s13054-018-2114-x

DO - 10.1186/s13054-018-2114-x

M3 - Review Article

VL - 22

JO - Critical Care

JF - Critical Care

SN - 1364-8535

IS - 1

M1 - 185

ER -