Analysis of transfusion reactions associated with prestorage-pooled platelet components

BACKGROUND: The goal of this study was to assess transfusion reactions arising from prestorage-pooled platelet (PSPP) infusions compared with apheresis single-donor platelets (SDPs) and poststorage-pooled, whole blood–derived random-donor platelets (RDPs). STUDY DESIGN AND METHODS: Over a span of 18 months, transfusion reaction records of patients receiving platelet (PLT) infusions were retrospectively reviewed at two academic, tertiary care hospitals. Chi-square analysis was used for statistical comparisons; significance was a p value of less than 0.05. RESULTS: For the two sites, 10,251 prestorage-leukoreduced PLT products were infused including 4731 PSPPs, 3999 SDPs, and 1521 RDPs. Of the total infusions, 0.91% (93/10,251) were associated with a transfusion reaction. The aggregate transfusion reaction rate was 0.89% (42/4731) for PSPPs, 0.75% (30/3999) for SDPs, and 1.38% (21/1521) for RDPs. There were no significant differences in total reaction rate between PSPPs and the other PLT products (p > 0.05). Allergic transfusion reactions were the most common adverse event for PLT products evaluated (63/10,251; 0.61%) and febrile reactions were second most common (27/10,251; 0.26%). There were 2 suspected cases of sepsis (1 associated with PSPP and 1 associated with RDP; both culture negative) and 1 case of volume overload associated with RDP infusion. There were no significant differences in aggregate allergic or febrile reaction rates among the 93 PLT products evaluated (p > 0.05). No reports of transfusion-related acute lung injury or hemolysis were noted. CONCLUSIONS: No difference in reactions rates was observed among PSPPs and the other PLT products. The transfusion reactions occurring in this population were not dependent on the type of PLT product infused.