Effect of storage time of platelet products on clinical outcomes after transfusion: a systematic review and meta-analyses

Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

Vox Sanguinis. 2017;112((4):):291-300
Abstract
BACKGROUND Prolonged storage improves availability of platelet products but could also influence safety and efficacy. This systematic review and meta-analyses summarize and quantify the evidence of the effect of storage time of transfused platelets on clinical outcomes. METHODS A systematic search in seven databases was performed up to February 2016. All studies reporting storage time of platelet products and clinical outcomes were included. To quantify heterogeneity, I(2) was calculated, and to assess publication bias, funnel plots were constructed. RESULTS Twenty-three studies reported safety outcomes and fifteen efficacy outcomes. The relative risk of a transfusion reaction after old platelets compared to fresh platelets was 1.53 (95% confidence interval (CI): 1.04-2.25) (12 studies). This was 2.05 (CI:1.47-2.85) before and 1.05 (CI: 0.60-1.84) after implementation of universal leucoreduction. The relative risk of bleeding was 1.13 (CI: 0.97-1.32) for old platelets compared to fresh (five studies). The transfusion interval was 0.25 days (CI: 0.13; 0.38) shorter after transfusion of old platelets (four studies). Three studies reported use of platelet products: two for haematological patients and one for trauma patients. Selecting only studies in haematological patients, the difference was 4.51 units (CI: 1.92; 7.11). CONCLUSION Old platelets increase the risk of transfusion reactions in the setting of non-leucoreduction, shorten platelet transfusion intervals, thereby increase the numbers of platelet transfusions in haematological patients, and may increase the risk of bleeding.
Study details
Study Design : Systematic Review
Language : English
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine