Single-donor platelets reduce the risk of septic platelet transfusion reactions

BACKGROUND: Septic platelet transfusion reactions (SPTRs) are the most comm on, serious risk of transfusion. Because SPTRs result from donor skin flora or asymptomatic bacteremia, the use of single-donor platelets (SDPs) has b een proposed to reduce the risk of SPTRs from the risks with pools of plate let concentrates (PCs). STUDY DESIGN AND METHODS: Beginning in 1986, all febrile transfusion reacti ons were evaluated by culture of the platelet bag. Confirmed SPTRs were ide ntified by isolation of the same bacteria from the bag and the patient's bl ood or by positive Gram's stain of the bag that confirmed a positive platel et culture. In 1987, a program to minimize PC use in favor of SDP use was i nitiated as a means of reducing SPTRs. RESULTS: In 12 years, the use of SDPs increased from 51.7 percent to 99.4 p ercent of all platelet transfusions at one institution. SPTRs fell from thr ee events in 1 year to the current rate of one event per year. The incidenc e of SPTRs decreased from 1 in 4,818 transfusions to 1 in 15,098 transfusio ns. The rate of SPTRs due to PCs was 5.39 times higher than that of SPTRs d ue to SDPs (95% CI, 1.89,12.9). CONCLUSION: The use of SDPs is a simple means of reducing SPTRs. Other meas ures such as sterilization will be required to eliminate all SPTRs.