Comparison of transfusion-outcome in patients with massive bleeding receiving pathogen-reduced platelets prepared with two different technologies.

BACKGROUND

Platelet concentrates(PCs) prepared with pathogen reduction technologies(PRT) are being used in routine treatment of onco-haematological patients since several years but less data are available for other pathologies.

STUDY DESIGN AND

METHODS

The aim of the study was to compare the efficacy of PCs prepared with two PRT for the treatment of patients with massive bleeding. The primary endpoint was the overall survival and in addition we analyzed the consumption of blood components in patients undergoing massive transfusion(MT). Subsequently we wanted to analyze additional known factors associated with higher in-hospital mortality. Retrospective analysis of two consecutive periods in which the PRT used were INTERCEPT and Mirasol, respectively.

RESULTS

A total of 313 patients were included (76 % males; median age: 63 years; 160 in the INTERCEPT group and 153 in the Mirasol group). We found significantly higher use of platelets in the Mirasol cohort, measured either in absolute per patient number of units (3vs.4; p = 0.002) or after adjustment for the number of transfused red blood cells. The risk of death increased with age and the outof-hospital onset of bleeding, even after adjustment for one another (sub-distribution hazard ratio[sHR] 2.53, 95 % confidence interval [CI] 1.75-3.66, p < 0.001, and sHR 2.56, 95 % CI 1.82-3.60, p < 0.001, respectively).

CONCLUSION

PRT applied to platelets did not influence MT-related mortality, but differences were found for the efficacy of the PCs treated with the different PRT which were reflected in a heightened demand for transfusion when utilizing Mirasol-treated PCs. Factors associated with higher mortality were older age and out-of-hospital bleeding.