Clinical Evaluation of Platelet Concentrates Either in Plasma or in Additive Solution

Abstract

Background and Objectives. Platelet concentrates (PC) obtained from Buffy-Coat (BC) may be diluted in a platelet additive solution (PAS). These PCs may reduce plasma-related adverse reactions. We have tried to assess the rela- tionship between PAS PCs and adverse reactions. Materials and Methods. During 6 months, patients treated with inten- sive chemotherapy, participated in a prospective study and were randomly assigned to receive, on a prophylactic basis, PCs in either plasma or PAS-2. Five iso-group BCs were pooled diluted in either plasma or PAS-2. One hour after each transfusion, corrected count increments (CCIs) were calculated, presence of hemorrhage and adverse reactions were re- corded. Results. Platelet increment, 1-hour platelet count, and corrected count increments (CCI) after transfusion in both groups were similar. There were more transfusion- dependent adverse reactions in plasma group. Conclusion. Use of PAS-2 resulted in less transfusion related reactions; therefore, we recommend synthetic additive solutions to dilute PCs. BACKGROUND AND OBJECTIVES Bleeding in a number of acute and chronic conditions that require medical and surgical treatment may be prevented and treated with platelet transfusions (1). Prophylactic plate- let concentrate (PC) transfusions in patients with severe thrombocytopenia have increased over the last years due to more frequent and more intensive radiations and chemother- apy treatments. PC may be obtained from whole blood col- lected into a multiple plastic bag set. The procedures for the preparation of PC from whole blood donations are the buffy- coat (BC) and the platelet-rich plasma (PRP) methods. The former one is performed in Europe and the latter in North America and in several European countries. PCs obtained from BC may be diluted in autologous plasma or in a platelet additive solution (PAS). The use of a synthetic medium re- duces the plasma content in every PC and therefore may re- duce plasma-related adverse reactions. We have performed a prospective clinical trial trying to assess the relationship be- tween PAS PCs, adverse reactions and their clinical effec- tiveness.