THE RELATIONSHIP BETWEEN THE DURATION OF PLATELET STORAGE AND THE DEVELOPMENT OF TRANSFUSION REACTIONS

BACKGROUND: The incidence of platelet transfusion reactions may depend partly on the length of storage. The influence of reactions on the ef fectiveness of platelet transfusions is not known. STUDY DESIGN AND ME THODS: Platelet transfusion reactions, identified by prospective monit oring, were analyzed for the effects of component type, recipient lymp hocytotoxic antibodies, bacterial contamination, and duration of stora ge. Posttransfusion corrected count increments (CCls) were used to eva luate the effectiveness of transfusions associated with reactions by c omparing them to those of randomly selected transfusions without react ions. RESULTS: Reactions accompanied 4 percent of the 4926 transfusion s given and included 119 febrile non-hemolytic transfusion reactions, 62 allergic reactions, and 13 reactions with features of both. Platele t concentrates contained a mean of 0.5 x 10(8) white cells per unit. L ymphocytotoxic antibodies were detectable in 20 of 84 recipients teste d proximate to a reaction. Bacterial cultures from 4 of 81 units were positive; 1 unit was associated with fatal Enterobacter sp. sepsis. Th e incidence of febrile nonhemolytic transfusion reactions but not alle rgic reactions was related to platelet storage duration. The CCl was n ot significantly different for transfusions associated with reactions (10.97 [median, range 0-72.5; n = 165]) or not so associated (13.1 [me dian, range O-39.5; n=174])(p=0.08). CONCLUSION: The incidence of febr ile nonhemolytic transfusion reactions but not allergic reactions appe ars to be related to the duration of platelet storage. Transfusion rea ctions may not have an adverse impact on the effectiveness of platelet transfusions.