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- Title
A pilot study to assess the hemostatic function of pathogen-reduced platelets in patients with thrombocytopenia.
- Authors
Johansson, Pär I.; Simonsen, Anne Catrine; Brown, Peter N.; Ostrowski, Sisse R.; Deberdt, Liesbeth; Van Hoydonck, Pascale; Yonemura, Susan S.; Goodrich, Raymond P.
- Abstract
Background Platelet ( PLT) support is critical to the care of patients with thrombocytopenia, but allogeneic transfusions carry risk. Pathogen reduction mitigates some transfusion risks, but effects on PLT function remain a concern. This clinical pilot study assessed the effect of pathogen reduction technology with riboflavin plus ultraviolet light using thrombelastography ( TEG). Study Design and Methods This prospective, randomized, crossover study compared Mirasol-treated ( MIR) and standard reference ( REF) PLT transfusions. PLT counts and TEG measurements were taken at pretransfusion and 1- and 24-hour-posttransfusion time points. The primary outcome measure was the pretransfusion to 1-hour-posttransfusion change in maximum amplitude (Δ MA1hr). Secondary endpoints included Δ MA among other time points, relative MA, and the PLT count- MA correlation. Results Of 16 enrolled patients, one withdrew before study treatment and three did not require two transfusions, leaving 12 patients in the efficacy analyses (seven MIR-REF, five REF-MIR). Δ MA1hr (mean ± SD) was 10.60 ± 6.47 mm for MIR and 14.33 ± 5.38 mm for REF (p = 0.20, n = 10). Δ MA24hr was 9.49 ± 7.94 for MIR and 7.13 ± 3.08 for REF (p = 0.38, n = 9); Δ MA24hr-1hr was −1.11 ± 2.95 for MIR and −7.20 ± 4.81 for REF (p = 0.016, n = 8). MA values for MIR and REF correlated with the log of PLT count ( rMIR = 0.6901, rREF = 0.7399). Conclusion TEG is sensitive to changes in hemostatic function resulting from a single PLT transfusion. MIR and REF provided similar increments in hemostatic function in the immediate posttransfusion period and at 24 hours. A significant difference detected for Δ MA24hr-1hr suggests different PLT clearance mechanisms. The relationship of these variables to clinically meaningful outcomes, for example, bleeding events or transfusion requirements, has yet to be determined.
- Subjects
BLOOD platelets; THROMBOCYTOPENIA; BLOOD transfusion; THROMBELASTOGRAPHY; HEMOSTATICS; BLOOD collection; CLINICAL trials
- Publication
Transfusion, 2013, Vol 53, Issue 9, p2043
- ISSN
0041-1132
- Publication type
Article
- DOI
10.1111/trf.12055