21:T4cd,

Objective.

—To determine the medical and laboratory characteristics of bacteremia secondary to transfusion of microbiologically contaminated platelet concentrates.

Design.

—Febrile transfusion reactions were prospectively monitored over 42 months. Units involved in reactions were evaluated with Gram's stain and culture tests.

Setting.

—Comprehensive cancer center.

Patients.

—Patients receiving platelet transfusions for thrombocytopenia secondary to bone marrow failure.

Result.

—Seven cases of transfusion-associated sepsis were observed. Multidonor platelet products stored for 5 days resulted in an incidence of sepsis five times higher than those stored for 4 days or less (P<.01). Investigation indicates that contamination most likely occurred at the time of blood collection. Clinically, septic reactions were associated with greater temperature elevations (average increase, 2.0°C) than febrile reactions to sterile products.

Conclusions.

—Contamination of platelet concentrates remains a significant clinical problem. Septic episodes may be reduced by transfusion of platelets with shorter storage intervals. (JAMA. 1991;266:555-558)22:T4cc,Seventy-nine platelet transfusions to 73 thrombocytopenic patients with cancer were analyzed to determine whether a platelet count obtained one hour after transfusion could help differentiate between alloimmunization and other clinical factors that result in rapid platelet destruction. These transfusions were selected because 18- to 24-hour increments were inadequate in response to fresh, random donor platelets. A corrected count increment (Cl) (Cl=[posttransfusion count-pretransfusion count]Xbody surface area [sq m]/platelets transfusedX10'') at one hour of 10X103/microliter or greater was associated with absence of lymphocytotoxic antibody, whereas increments of less than 10X103/microliter were generally associated with high levels of strongly cytotoxic antibody. HLA-matched transfusions produced no improvement in increments when the previous one-hour Cl had been 10X103/microliter or greater, whereas in the other group significantly better increments were obtained. A one-hour posttransfusion count is a simple test that correlates well with the presence of antibody against HLA antigens, is valuable in predicting the need for HLA-matched platelets, and helps avoid wasteful, empirical use of such transfusions.23:T509,Seventy-nine platelet transfusions to 73 thrombocytopenic patients with cancer were analyzed to determine whether a platelet count obtained one hour after transfusion could help differentiate between alloimmunization and other clinical factors that result in rapid platelet destruction. These transfusions were selected because 18- to 24-hour increments were inadequate in response to fresh, random donor platelets. A corrected count increment (CI) (CI=[posttransfusion count—pretransfusion count]×body surface area [sq m]/platelets transfused×10¹¹) at one hour of 10×10³/μL or greater was associated with absence of lymphocytotoxic antibody, whereas increments of less than 10×10³/μL were generally associated with high levels of strongly cytotoxic antibody. HLA-matched transfusions produced no improvement in increments when the previous one-hour CI had been 10×10³/μL or greater, whereas in the other group significantly better increments were obtained. A one-hour posttransfusion count is a simple test that correlates well with the presence of antibody against HLA antigens, is valuable in predicting the need for HLA-matched platelets, and helps avoid wasteful, empirical use of such transfusions. (JAMA243:435-438, 1980)

	Year	Citations

Abstract

References