(P-TS-46) Evaluating The Safety Of Pathogen-Reduced Platelets In Pediatric Patients: A Comparative Study

Pathogen-reduced (PR) platelets are increasingly utilized to enhance transfusion safety by mitigating the risk of transfusion-transmitted infections and complications. Prior research highlights their efficacy, yet data in pediatric settings are sparse. This study assesses the safety of PR platelets in a pediatric population by analyzing transfusion reactions before and after PR implementation at a major pediatric center.

Study

Design/Methods: A retrospective analysis was conducted on 18,460 platelet transfusions involving 2,627 pediatric patients. We compared the incidence and types of transfusion reactions over two 30-month periods: before (August 20, 2018, to February 20, 2021) and after (February 21, 2021, to August 21, 2023) the adoption of PR platelets. Reactions were categorized as acute hypotensive, febrile non-hemolytic transfusion reactions (FNHTR), allergic reactions, transfusion-transmitted infections (TTI), circulatory overload (TACO), acute lung injury (TRALI), and transfusion-associated dyspnea (TAD) using the category definitions from the CDC National Healthcare Safety Network (NHSN). The chi-squared test was utilized to evaluate statistical significance.

Results/Findings: Before PR implementation, we documented 102 reactions from 9,671 transfusions using predominantly traditional apheresis platelets (9,387), washed platelets (280), PAS platelets (1), and a minimal use of PR platelets (3). Post-implementation, from 8,789 transfusions, 103 reactions were recorded using PR platelets (5,116), Large Volume Delayed Sampling (LVDS) 48 (2,927), traditional apheresis (591), and washed platelets (155). The analysis revealed no significant difference in the overall rate or distribution of reaction types between the two periods (chi-squared statistic = 10.5, degrees of freedom = 6, p-value = 0.10). No TRALI or transfusion-transmitted infections were reported in the PR group, though one TTI was associated with an LVDS 48 platelet (See Table 1).

Conclusions:

The introduction of PR platelets at our pediatric center did not increase the incidence of transfusion reactions, underscoring their safety and reinforcing their role in reducing pathogen transmission without heightening adverse effects. Our findings support the continued adoption of PR platelets in pediatric transfusion practices.