Storage time of platelet concentrates and risk of a positive blood culture: a nationwide cohort study

TY - JOUR

T1 - Storage time of platelet concentrates and risk of a positive blood culture

T2 - a nationwide cohort study

AU - Kreuger, Aukje L

AU - Rostgaard, Klaus

AU - Middelburg, Rutger A

AU - Kerkhoffs, Jean-Louis H

AU - Edgren, Gustav

AU - Erikstrup, Christian

AU - Pedersen, Ole B

AU - Titlestad, Kjell

AU - Nielsen, Kaspar R

AU - Ostrowski, Sisse R

AU - Voldstedlund, Marianne

AU - van der Bom, Johanna G

AU - Ullum, Henrik

AU - Hjalgrim, Henrik

N1 - © 2017 AABB.

PY - 2018/1

Y1 - 2018/1

N2 - BACKGROUND: Concern of transfusion-transmitted bacterial infections has been the major hurdle to extend shelf life of platelet (PLT) concentrates. We aimed to investigate the association between storage time and risk of positive blood cultures at different times after transfusion.STUDY DESIGN AND METHODS: We performed a nationwide cohort study among PLT transfusion recipients in Denmark between 2010 and 2012, as recorded in the Scandinavian Donations and Transfusions (SCANDAT2) database. Linking with a nationwide database on blood cultures (MiBa), we compared the incidence of a positive blood culture among recipients of PLTs stored 6 to 7 days (old) to those receiving fresh PLTs (1-5 days), using Poisson regression models. We considered cumulative exposures in windows of 1, 3, 5, and 7 days.RESULTS: A total of 9776 patients received 66,101 PLT transfusions. The incidence rate ratio (IRR) of a positive blood culture the day after transfusion of at least one old PLT concentrate was 0.77 (95% confidence interval [CI], 0.54-1.09) compared to transfusion of fresh PLT concentrates. The incidence rate of a positive blood culture was lower the day after receiving one old compared to one fresh PLT concentrate (IRR, 0.57; 95% CI, 0.37-0.87). Three, 5, or 7 days after transfusion, storage time was not associated with the risk of a positive blood culture.CONCLUSION: Storage of buffy coat-derived PLT concentrates in PAS-C up to 7 days seems safe regarding the risk of a positive blood culture. If anything, transfusion of a single old PLT concentrate may decrease this risk the following day.

AB - BACKGROUND: Concern of transfusion-transmitted bacterial infections has been the major hurdle to extend shelf life of platelet (PLT) concentrates. We aimed to investigate the association between storage time and risk of positive blood cultures at different times after transfusion.STUDY DESIGN AND METHODS: We performed a nationwide cohort study among PLT transfusion recipients in Denmark between 2010 and 2012, as recorded in the Scandinavian Donations and Transfusions (SCANDAT2) database. Linking with a nationwide database on blood cultures (MiBa), we compared the incidence of a positive blood culture among recipients of PLTs stored 6 to 7 days (old) to those receiving fresh PLTs (1-5 days), using Poisson regression models. We considered cumulative exposures in windows of 1, 3, 5, and 7 days.RESULTS: A total of 9776 patients received 66,101 PLT transfusions. The incidence rate ratio (IRR) of a positive blood culture the day after transfusion of at least one old PLT concentrate was 0.77 (95% confidence interval [CI], 0.54-1.09) compared to transfusion of fresh PLT concentrates. The incidence rate of a positive blood culture was lower the day after receiving one old compared to one fresh PLT concentrate (IRR, 0.57; 95% CI, 0.37-0.87). Three, 5, or 7 days after transfusion, storage time was not associated with the risk of a positive blood culture.CONCLUSION: Storage of buffy coat-derived PLT concentrates in PAS-C up to 7 days seems safe regarding the risk of a positive blood culture. If anything, transfusion of a single old PLT concentrate may decrease this risk the following day.

KW - Adolescent

KW - Adult

KW - Aged, 80 and over

KW - Bacteremia/epidemiology

KW - Blood Platelets

KW - Blood Preservation/methods

KW - Cohort Studies

KW - Denmark/epidemiology

KW - Female

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Platelet Transfusion/adverse effects

KW - Time Factors

KW - Young Adult

U2 - 10.1111/trf.14401

DO - 10.1111/trf.14401

M3 - Journal article

C2 - 29168187

SN - 0041-1132

VL - 58

SP - 16

EP - 24

JO - Transfusion

JF - Transfusion

IS - 1

ER -