PREVALENCE OF PLATELET TRANSFUSION REACTIONS BEFORE AND AFTER IMPLEMENTATION OF LEUKOCYTE-DEPLETED PLATELET CONCENTRATES BY FILTRATION

To determine the impact of platelet leukodepletion by filtration on th e overall prevalence of reported transfusion reactions associated with platelet concentrates, we audited platelet transfusion reactions afte r infusion of platelet concentrates reported at University Hospitals o f Cleveland over 6 months before (interval 1, July 1, 1989 to December 31,1989) and after (interval 2, July 1, 1990 to December 31, 1990) im plementation of the Pall PL 50 filter on our adult Hematology-Oncology inpatient unit (Division 60). Thirty-two (1.7%) of 1,901 random, pool ed platelet transfusion events resulted in blood bank transfusion reac tion workups in interval 1, compared to 90 (5.3%) of 1,704 in interval 2 (p < 0.001). The Division 60 service accounted for more of our hosp ital-wide platelet reactions after implementation of the filter in int erval 2 (84%) than before filtration in interval 1 (42%), p = 0.002. T he prevalence of reaction workups for Division 60 was 0.6% for interva l 1, compared to 4.3% for interval 2 (p < 0.001). No differences were found between interval 1 and interval 2 for the rate of discontinuatio n of platelet transfusion (36 vs. 32%, p = 0.14), rate of premedicatio n for platelet transfusion (72 vs. 65 %, p = 0.6), percentage of direc t antiglobulin test-positive reactions (17 vs. 5.4%, p = 0.09), percen tage showing icteric/hemolyzed serum (15 vs. 4.4%, p = 0.09), or react ions believed to be due to red blood cell incompatibility (8.8 vs. 1.1 %, p = 0.1). We conclude that the use of expensive platelet filtration devices has not decreased the morbidity of random, pooled platelet tr ansfusions, nor the prevalence of time-consuming blood bank evaluation of platelet transfusion reactions in this setting.