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Background: Extension of storage time of platelet (PLT) concentrates may result in an increased risk of bacteremia, directly via transfusion of contaminated products or indirectly via transfusion-related immunomodulation. We aimed to quantify the association of storage time of PLT concentrates and all-cause bacteremia in hematologic patients., Study Design and Methods: We established a cohort of hematologic patients who received a PLT transfusion between 2005 and 2015. Cases were defined as patients with a bacteremia the day after transfusion and matched to as many controls as possible. A conditional logistic regression was performed, stratified by storage medium., Results: Among 3514 patients receiving 36,032 PLT concentrates stored in plasma, 613 cases of bacteremia were found. The relative risk of all-cause bacteremia the day after transfusion was 0.80 (95% confidence interval [CI], 0.58-1.12) for PLT concentrates stored 3 to 4 days and 0.67 (95% CI, 0.49-0.92) for at least 5 days, compared to no more than 2 days. Among 1527 patients receiving 11,822 PLT concentrates stored in PLT additive solution, 182 cases of bacteremia were found. The relative risk of all-cause bacteremia was 1.14 (95% CI, 0.70-1.84) for PLT concentrates stored for 3 to 4 days and 1.19 (95% CI, 0.70-2.01) for at least 5 days, compared to not more than 2 days., Conclusion: Storage time of PLT concentrates was not associated with increased occurrence of all-cause bacteremia the day after transfusion. If anything, fewer cases of bacteremia occurred with increasing storage time of PLT concentrates in plasma. These bacteremias are not directly caused by transfusion of a contaminated product and the underlying mechanism warrants further research., (© 2017 AABB.)

Introduction: In 2018, platelet (PLT) additive solution‐E (PAS‐E) was introduced. The implementation of PAS‐E was expected to diminish the number of allergic reactions in recipients following a PLT transfusion. Here, we evaluated the efficacy and safety of transfusions with PLTs stored in PAS‐E. Study Design and Methods: After implementation of PAS‐E, data were collected from 2 cohorts of patients with hematological disorders as well as oncology patients, receiving PLTs in PAS‐E. A similar patient group in a recent RCT, receiving PLTs in plasma, was used as a historical control group for both cohorts. Endpoints were corrected count increments (CCIs), bleeding scores (only reported in cohort 1), and the incidence of adverse reactions. Results: In cohort 1, the mean 1‐h CCI was 14.3 ± 6.9, and the 24‐h CCI was 8.7 ± 5.6. In cohort 2, the 1‐h CCI was 11.6 ± 7.8 and the 24‐h CCI was 7.0 ± 6.1. In the control group, the 1‐h CCI was 15.4 ± 5.5 and 24‐h CCI 8.7 ± 4.8. Bleeding complications of WHO grade ≥2 occurred in 40% of patients in cohort 1 compared to 44% in plasma PCs. The incidence of adverse reactions was 1.2% in the two PAS‐E cohorts, compared to 3.0% in plasma PCs. National hemovigilance data showed a significant reduction in allergic reactions with PAS‐E PC transfusions as compared to plasma PCs with an odds ratio of 0.46 (CI 95% 0.37–0.58). Conclusion: The CCIs of PLTs in PAS‐E were decreased compared to plasma PCs, but clinically acceptable. Allergic transfusion reactions were decreased in PAS‐E PCs compared to plasma PCs. [ABSTRACT FROM AUTHOR]