The safety of platelet (PLT) concentrates with longer storage duration has been questioned due to biochemical and functional changes that occur during blood collection and storage. Some studies have suggested that transfusion efficacy is decreased and immune system dysfunction is worsened with increased storage age. We sought to describe the effect of PLT storage age on laboratory and clinical outcomes in critically ill children receiving PLT transfusions. Study Design and Methods: We performed a secondary analysis of a prospective, observational point-prevalence study. Children (3 days to 16 years of age) from 82 pediatric intensive care units in 16 countries were enrolled if they received a PLT transfusion during one of the predefined screening weeks. Outcomes (including PLT count increments, organ dysfunction, and transfusion reactions) were evaluated by PLT storage age. Results: Data from 497 patients were analyzed. The age of the PLT transfusions ranged from 1 to 7 days but the majority were 4 (24%) or 5 (36%) days of age. Nearly two-thirds of PLT concentrates were transfused to prevent bleeding. The indication for transfusion did not differ between storage age groups (P =.610). After patient and product variables were adjusted for, there was no association between storage age and incremental change in total PLT count or organ dysfunction scoring. A significant association between fresher storage age and febrile transfusion reactions (P =.002) was observed. Conclusion: The results in a large, diverse cohort of critically ill children raise questions about the impact of storage age on transfusion and clinical outcomes which require further prospective evaluation.
Bibliographical noteFunding Information:
This project was supported in part by funds from the Clinical Translational Science Center (CTSC), National Center for Advancing Translational Sciences (NCATS) grant #UL1‐TR000457. Funding information
The authors thank all the P3T investigators for their contribution as well as the Clinical Translational Science Center (CTSC) at Weill Cornell Medical College Medicine. P3T Investigators: Australia: Warwick Butt, Carmel Delzoppo (Royal Children's Hospital, Melbourne); Simon Erickson, Elizabeth Croston, Samantha Barr (Princess Margaret Hospital, Perth); Elena Cavazzoni (Children's Hospital at Westmead, Sydney). Belgium: Annick de Jaeger (Princess Elisabeth Children's University Hospital, Ghent). Canada: Marisa Tucci, Mary-Ellen French, Marion Ropars, Lucy Clayton (CHU Sainte-Justine, Montreal, QC); Srinivas Murthy, Gordon Krahn (British Columbia Children's Hospital, Vancouver, BC). China: Dong Qu, Yi Hui (Children's Hospital Capital Institute of Pediatrics, Beijing). Denmark: Mathias Johansen, Anne-Mette Baek Jensen, Inge-Lise Jarnvig, Ditte Strange (Rigshospitalet, University of Copenhagen, Copenhagen). India: Muralidharan Jayashree, Mounika Reddy (Postgraduate Institute of Medical Education and Research, Chandigarh); Jhuma Sankar, U. Vijay Kumar, Rakesh Lodha (All India Institute of Medical Sciences, New Delhi). Israel: Reut Kassif Lerner, Gideon Paret (The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan); Ofer Schiller, Eran Shostak, Ovadia Dagan (Schneider Children's Medical Center, Petah Tikva); Yuval Cavari (Soroka University Medical Center, Beersheva). Italy: Fabrizio Chiusolo, Annagrazia Cillis (Bambino Gesu Children's Hospital, Rome); Anna Camporesi (Children's Hospital Vittore Buzzi, Milano). Netherlands: Martin Kneyber (Beatrix Children's Hospital, Groningen); Suzan Cochius-den Otter, Ellen Van Hemeldonck (Erasmus MC- Sophia Children's Hospital, Rotterdam). New Zealand: John Beca, Claire Sherring, Miriam Rea (Starship Child Health, Auckland). Portugal: Clara Abadesso, Marta Moniz (Hospital Prof. Dr. Fernando Fonseca, Amadora). Saudi Arabia: Saleh Alshehri (King Saud Medical City, Riyadh). Spain: Jesus Lopez-Herce, Irene Ortiz, Miriam Garcia (Hospital General Universitario Gregorio Maranon, Madrid); Iolanda Jordan (Institut de Recerca Hospital Sant Joan de Deu, Barcelona); J. Carlos Flores Gonzalez (Hospital Universitario Puerta del Mar, Cadiz); Antonio Perez-Ferrer, Ana Pascual-Albitre (La Paz University Hospital, Madrid). Switzerland: Serge Grazioli (University Hospital of Geneva, Geneva); Carsten Doell (University Children's Hospital Zurich, Zurich). United Kingdom: Peter J. Davis (Bristol Royal Hospital for Children, Bristol); Ilaria Curio, Andrew Jones, Mark J. Peters (Great Ormond St Hospital NHS Trust and NIHR Biomedical Research Centre, London); Jon Lillie (Evelina London Children's Hospital, London); Angela Aramburo, Medhat Shabana, Priya Ramachandran, Helena Sampaio (Royal Brompton Hospital, London); Kalaimaran Sadasivam (Royal London Hospital, Barts Health NHS Trust, London); Nicholas J. Prince (St George's Hospital, London); Hari Krishnan Kanthimathinathan (Birmingham Children's Hospital, Birmingham); Ricardo Garcia Branco (Cambridge University Hospitals NHS Trust, Cambridge); Kim L. Sykes, Christie Mellish (University Hospital Southampton, Southampton); Avishay Sarfatti, James Weitz (Oxford University Hospitals NHS Foundation Trust, Oxford). United States: Ron C. Sanders Jr, Glenda Hefley (Arkansas Children's Hospital, Little Rock, AR); Rica Sharon P. Morzov, Barry Markovitz (Children's Hospital Los Angeles, Los Angeles, CA); Anna Ratiu, Anil Sapru (Mattel's Children's Hospital, Los Angeles, CA); Allison S. Cowl (Connecticut Children's Medical Center, Hartford, CT); E. Vincent, S. Faustino (Yale School of Medicine, New Haven, CT); Shruthi Mahadevaiah (University of Florida Shands Children's Hospital, Gainesville, FL); Fernando Beltramo (Nicklaus Children's Hospital, Miami, FL); Asumthia S. Jeyapalan, Mary K. Cousins (University of Miami/Holtz Children's Hospital, Miami, FL); Cheryl Stone, James Fortenberry (Children's Healthcare of Atlanta, Atlanta, GA); Neethi P. Pinto, Chiara Rodgers, Allison Kniola (The University of Chicago, Chicago, IL); Melissa Porter, Erin Owen, Kristen Lee, Laura J. Thomas (University of Louisville, Kosair Charities Pediatric Clinical Research Unit, and Norton Children's Hospital, Louisville, KY); Melania M. Bembea, Ronke Awojoodu (Johns Hopkins University, Baltimore, MD); Daniel Kelly, Kyle Hughes (Boston Children's Hospital, Boston, MA); Zenab Mansoor, Carol Pineda (Tufts Floating Hospital for Children, Boston, MA); Phoebe H. Yager, Maureen Clark (Massachusetts General Hospital, Boston, MA); Scot T. Bateman (UMass Memorial Children's Medical Center, Worcester, MA); Kevin W. Kuo, Erin F. Carlton (C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI); Brian Boville, Mara Leimanis (Helen DeVos Children's Hospital, Grand Rapids, MI); Marie E. Steiner, Dan Nerheim (University of Minnesota Masonic Children's Hospital, Minneapolis, MN); Kenneth E. Remy, Lauren Langford, Melissa Schicker (Washington University in St Louis, St Louis, MO); Marcy N. Singleton, J. Dean Jarvis, Sholeen T. Nett (Dartmouth-Hitchcock Medical Center, Lebanon, NH); Shira Gertz (Hackensack University Medical Center, Hackensack, NJ); Ruchika Goel (New York Presbyterian Hospital–Weill Cornell Medical College Medicine, New York, NY); James S. Killinger, Meghan Sturnhahn (Memorial Sloan Kettering Cancer Center, New York, NY); Margaret M. Parker, Ilana Harwayne-Gidansky (Stony Brook Children's Hospital, Stony Brook, NY); Laura A. Watkins (Cohen Children's Medical Center, Northwell Health, Queens, NY); Gina Cassel, Adi Aran, Shubhi Kaushik (The Children's Hospital at Montefiore, Bronx, NY); Andy Y. Wen (NYU Langone Medical Center, NYU School of Medicine, New York, NY); Amanda B. Hassinger (Women and Children's Hospital of Buffalo, Buffalo, NY); Caroline P. Ozment, Candice M. Ray (Duke Children's Hospital and Health Center, Durham, NC); Michael C. McCrory, Andora L. Bass (Wake Forest Brenner Children's Hospital, Winston-Salem, NC); Michael T. Bigham, Heather Anthony (Akron Children's Hospital, Akron, OH); Jennifer A. Muszynski, Jill Popelka (Nationwide Children's Hospital, Columbus, OH); Julie C. Fitzgerald, Susan Doney Leonard (Children's Hospital of Philadelphia, Philadelphia, PA); Neal J. Thomas, Debbie Spear (Penn State Hershey Children's Hospital, Hershey, PA); Whitney E. Marvin (Medical University of South Carolina, Charleston, SC); Arun Saini; Alina Nico West (Health Science Center, University of Tennessee, and Le BonHeur Children's Hospital, Memphis, TN); Jennifer McArthur, Angela Norris, Saad Ghafoor, Ashlea Anderson (St Jude Children's Research Hospital, Memphis, TN); Tracey Monjure, Kris Bysani (Medical City Children's Hospital, Dallas, TX); LeeAnn M. Christie (Dell Children's Medical Center, Austin, TX); Laura L. Loftis (Baylor College of Medicine, Texas Children's Hospital, Houston, TX); Andrew D. Meyer, Robin Tragus, Holly Dibrell, David Rupert (University of Texas Health Science Center at San Antonio, San Antonio, TX); Claudia Delgado-Corcoran, Stephanie Bodily (University of Utah, Primary Children's Hospital, Salt Lake City, UT); Douglas Willson (Children's Hospital of Richmond at VCU, Richmond, VA); Leslie A. Dervan (Seattle Children's, University of Washington, Seattle, WA); Sheila J. Hanson (Medical College of Wisconsin/Children's Hospital of Wisconsin, Milwaukee, WI); Scott A. Hagen, Awni M. Al-Subu (University of Wisconsin School of Medicine and Public Health, Madison, WI).
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