Impact of platelet pathogen inactivation on blood component utilization and patient safety in a large Austrian Regional Medical Centre

BackgroundIn clinical studies, pathogen inactivation (PI) of platelet concentrates (PC) with amotosalen and UVA light did not impact patient risk for haemorrhage but may affect transfusion frequency and component utilization. We evaluated the influence of platelet PI on PC, red cell concentrate (RCC) and plasma use and safety in routine practice in a large regional hospital. Study Design and MethodsComparative effectiveness of conventional vs. PI-treated PC was analysed during two 21-month periods, before and after PI implementation. ResultsSimilar numbers of patients were transfused in the pre-PI (control, 1797) and post-PI (test, 1694) periods with comparable numbers of PC (8611 and 7705, respectively). The mean numbers of PC per patient transfused (48 vs. 45, P = 043) were not different but days of PC support (59 vs. 50, P < 001) decreased. Most patients received RCC (868% control vs. 848% test, P = 090) with similar mean numbers transfused (108 vs. 102 RCC, P = 022), and fewer patients (554% control vs. 447% test, P < 001) received less plasma units (mean 99 vs. 78, respectively, P < 001) in the test period. The frequencies of transfusion-related adverse events (AE) were comparable (13% vs. 14%, P = 095). Analysis of haematology-oncology (522 control, 452 test), cardiac surgery (739 control, 711 test), paediatric (157 control, 130 test) and neonate (23 control, 20 test) patients revealed no increase in PC, plasma and RCC utilization, or AE. ConclusionComponent utilization and patient safety were not impacted by adoption of PI for PC. RCC use per patient was comparable, suggestive of no increase in significant bleeding.