Platelet transfusions and patient outcomes after cardiac surgery

Platelet transfusions are used to provide hemostatic capacity to patients with decreased number or functionality of platelets. The aim of this thesis was to expand knowledge about the safety and efficacy of platelet transfusions in general and in particular in cardiac surgery patients. In this thesis we found that cardiac surgery patients receiving an platelet transfusion shortly after cardiopulmonary bypass experienced less blood loss than patients who did not receive an early platelet transfusion. However, early platelet transfusion was not associated with more reinterventions, thromboembolic complications, infections, multi-organ failure, or mortality. Furthermore, we discovered that PAS-C as storage medium for platelets is associated with more favorable outcomes than plasma with regard to transfusions reactions, but not with regard to in vitro hemostatic measurements. Furthermore, we observed that fresh platelet concentrates are associated with more favorable outcomes than older platelet concentrates: less transfusions reactions in the whole transfused population, better hemostatic measurements in vitro, and less blood loss and mortality in cardiac surgery patients.Sanquin Blood Supply, Dutch Heart Foundation, Amphia Hospital,Chipsoft, Prof. dr. Henkes Stichting, Leiden University, Oculenti Contactlenspraktijken, Rockmed, Santen, Synga Medical, Thea Pharma, Vitaminen op ReceptLUMC / Geneeskund

Platelet transfusions and patient outcomes after cardiac surgery

Platelet transfusions are used to provide hemostatic capacity to patients with decreased number or functionality of platelets. The aim of this thesis was to expand knowledge about the safety and efficacy of platelet transfusions in general and in particular in cardiac surgery patients. In this thesis we found that cardiac surgery patients receiving an platelet transfusion shortly after cardiopulmonary bypass experienced less blood loss than patients who did not receive an early platelet transfusion. However, early platelet transfusion was not associated with more reinterventions, thromboembolic complications, infections, multi-organ failure, or mortality. Furthermore, we discovered that PAS-C as storage medium for platelets is associated with more favorable outcomes than plasma with regard to transfusions reactions, but not with regard to in vitro hemostatic measurements. Furthermore, we observed that fresh platelet concentrates are associated with more favorable outcomes than older platelet concentrates: less transfusions reactions in the whole transfused population, better hemostatic measurements in vitro, and less blood loss and mortality in cardiac surgery patients.</p

Platelet transfusions and patient outcomes after cardiac surgery

Platelet transfusions are used to provide hemostatic capacity to patients with decreased number or functionality of platelets. The aim of this thesis was to expand knowledge about the safety and efficacy of platelet transfusions in general and in particular in cardiac surgery patients. In this thesis we found that cardiac surgery patients receiving an platelet transfusion shortly after cardiopulmonary bypass experienced less blood loss than patients who did not receive an early platelet transfusion. However, early platelet transfusion was not associated with more reinterventions, thromboembolic complications, infections, multi-organ failure, or mortality. Furthermore, we discovered that PAS-C as storage medium for platelets is associated with more favorable outcomes than plasma with regard to transfusions reactions, but not with regard to in vitro hemostatic measurements. Furthermore, we observed that fresh platelet concentrates are associated with more favorable outcomes than older platelet concentrates: less transfusions reactions in the whole transfused population, better hemostatic measurements in vitro, and less blood loss and mortality in cardiac surgery patients.</p

Patient Experience with Current Clinical Decision Making in Prosthetic Aortic Valve Selection

Cardiolog

Transfusion reactions after transfusion of platelets stored in PAS-B, PAS-C, or plasma: a nationwide comparison

Clinical epidemiolog

Long-term results of mitral valve repair for severe mitral regurgitation in asymptomatic patients

Cardiolog

Are thrombocytopenia and platelet transfusions associated with major bleeding in preterm neonates? A systematic review

Clinical epidemiolog

Comparing transfusion reaction rates for various plasma types: a systematic review and meta-analysis/regression

Development and application of statistical models for medical scientific researc

Effect of storage of platelet concentrates in PAS-B, PAS-C, or plasma on transfusion reactions

BACKGROUND Reports on the clinical consequences of longer storage time of platelet concentrates are contradictory. The objective of this study was to assess whether longer storage times are associated with a higher risk of transfusion reactions. STUDY DESIGN AND METHODS We gathered storage times of pooled platelet concentrates related to transfusion reactions reported to the national hemovigilance office from 2004 to 2015. These were combined with storage times of platelet concentrates in the reference population to compare incidences of transfusion-associated circulatory overload, transfusion-related acute lung injury, allergic reactions, febrile nonhemolytic reactions, and "other" reactions between storage time categories. RESULTS A total of 567,053 platelet concentrates and 1870 transfusion reactions were analyzed. Among platelet additive solution (PAS)-B platelet recipients, the odds ratio of a storage time of 4 to 5 days compared to 1 to 3 days was 1.60 (95% confidence interval [CI], 1.17-2.18) for allergic, and 1.47 (1.09-1.98) for febrile reactions. For PAS-C platelet recipients, the odds ratio for allergic reactions was 3.78 (95% CI, 1.31-10.9) for 4 to 5 days, and 4.57 (95% CI, 1.57-13.4) for 6- to 7-day-old platelets when compared to 1- to 3-day-old units. In all other studied reaction types, no statistically significant association was observed in platelets in plasma, PAS-B, and PAS-C. CONCLUSIONS In plasma platelets, longer storage time was not associated with a higher incidence of transfusion reactions. In PAS platelets, longer storage time was associated with higher transfusion reaction incidences, in particular for allergic reactions with both PAS fluids and febrile reactions with PAS-B. This indicates that the effect of storage time is different for different reaction types and depends on the storage fluid.Clinical epidemiolog