Febrile reactions after platelet transfusion: the effect of single versus multiple donors

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Abstract
Febrile reactions to platelet transfusions are a common problem. The platelet transfusion records from a 30‐month period were analyzed to determine 1) when reactions occur in a transfusion sequence; 2) how frequently they recur; and 3) whether the choice of multiple‐donor (pooled concentrates) or single‐donor components (unmatched apheresis and HLA‐compatible apheresis platelets) affected the reaction rate. Overall, 18.7 percent of all patients receiving platelets experienced reactions. A subset of 85 patients, who began platelet support with unmodified components during the study interval, were analyzed in detail. This group received 1204 unmodified transfusions (mean, 14.2/patient), which were associated with 171 reactions (per‐transfusion reaction rate, 14.2%). Despite a higher mean white cell content, the transfusion of 438 unmatched single‐donor platelets (10.84 times 108 white cells, 8.4% reaction rate) resulted in reactions significantly less often than did that of 583 pooled concentrates (8.53 times 108 white cells, 21.4% reaction rate)(p<0.001). The rate of reaction to HLA‐compatible platelets (9/183 transfusions, 4.9%) was not significantly different from that to unmatched single‐donor platelets. The use of platelet components from one donor, as opposed to multiple donors, may provide an effective means of reducing the incidence of febrile reactions.