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Factors influencing moderate to severe reactions to PLT transfusions: experience of the TRAP multicenter clinical trial
Author(s) -
Enright Helen,
Davis Kathryn,
Gernsheimer Terry,
McCullough Jeffrey J.,
Woodson Robert,
Slichter Sherrill J.
Publication year - 2003
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.2003.00529.x
Subject(s) - apheresis , medicine , chills , plateletpheresis , platelet , bronchospasm , platelet transfusion , refractory (planetary science) , blood transfusion , surgery , anesthesia , blood product , physics , astrobiology , asthma
BACKGROUND: During the Trial to Reduce Alloimmunization to Platelets (TRAP Trial), data were prospectively collected for 8769 PLT transfusions regarding the frequency of moderate to severe PLT transfusion reactions. STUDY DESIGN AND METHODS: At seven centers, 598 patients were randomly assigned to receive unmodified pooled random‐donor PLT concentrates (PCs), UV‐B‐irradiated PCs, filtered PCs, or filtered random‐donor apheresis PLTs. RESULTS: Moderate to severe transfusion reactions were an increase in temperature of at least 2°C, chills with rigors, extensive urticaria, dyspnea, cyanosis, or bronchospasm. These reactions occurred with 2.2 percent of the transfusions in 22 percent of the patients. Transfusion reactions were associated with WBC counts of more than 5 × 10 6 per transfusion (p = 0.002) and transfusions stored for more than 48 hours (p = 0.02). PLT counts before transfusion were significantly lower for transfusions associated with reactions (p = 0.005). Neither UV‐B irradiation nor apheresis PLTs independently influenced reaction rates. The PLT increment at 1 hour after transfusion was lower for transfusions associated with reactions (p = 0.004), and the frequency of reactions was higher in PLT refractory patients (p < 0.001). CONCLUSIONS: The provision of either fresh and/or WBC‐reduced PLTs may decrease the frequency of PLT transfusion reactions and improve PLT transfusion efficacy.