TY - JOUR
T1 - Effects of ABO matching of platelet transfusions in critically III children
AU - Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, Pediatric Critical Care Blood Research Network (BloodNet), and the P3 T Investigators
AU - Nellis, Marianne E.
AU - Goel, Ruchika
AU - Karam, Oliver
AU - Cushing, Melissa M.
AU - Davis, Peter J.
AU - Steiner, Marie E.
AU - Tucci, Marisa
AU - Stanworth, Simon J.
AU - Spinella, Philip C.
AU - Butt, Warwick
AU - Delzoppo, Carmel
AU - Erickson, Simon
AU - Croston, Elizabeth
AU - Barr, Samantha
AU - Cavazzoni, Elena
AU - de Jaeger, Annick
AU - Tucci, Marisa
AU - French, Mary Ellen
AU - Ropars, Marion
AU - Clayton, Lucy
AU - Murthy, Srinivas
AU - Krahn, Gordon
AU - Qu, Dong
AU - Hui, Yi
AU - Johansen, Mathias
AU - Jensen, Anne Mette Baek
AU - Jarnvig, Inge Lise
AU - Strange, Ditte
AU - Jayashree, Muralidharan
AU - Reddy, Mounika
AU - Sankar, Jhuma
AU - Kumar, U. Vijay
AU - Lodha, Rakesh
AU - Lerner, Reut Kassif
AU - Paret, Gideon
AU - Schiller, Ofer
AU - Shostak, Eran
AU - Dagan, Ovadia
AU - Cavari, Yuval
AU - Chiusolo, Fabrizio
AU - Cillis, Annagrazia
AU - Camporesi, Anna
AU - Kneyber, Martin
AU - Otter, Suzan Cochius Den
AU - Van Hemeldonck, Ellen
AU - Beca, John
AU - Sherring, Claire
AU - Rea, Miriam
AU - Abadesso, Clara
AU - Hassinger, Amanda B.
N1 - Publisher Copyright:
© 2018 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Objectives: To determine if transfusing ABO compatible platelets has a greater effect on incremental change in platelet count as compared to ABO incompatible platelets in critically ill children. Design: Secondary analysis of a prospective, observational study. Transfusions were classified as either ABO compatible, major incompatibility, or minor incompatibility. The primary outcome was the incremental change in platelet count. Transfusion reactions were analyzed as a secondary outcome. Setting: Eighty-two PICUs in 16 countries. Patients: Children (3 d to 16 yr old) were enrolled if they received a platelet transfusion during one of the predefined screening weeks. Interventions: None. Measurements and Main Results: Five-hundred three children were enrolled and had complete ABO information for both donor and recipient, as well as laboratory data. Three-hundred forty-two (68%) received ABO-identical platelets, 133 (26%) received platelets with major incompatibility, and 28 (6%) received platelets with minor incompatibility. Age, weight, proportion with mechanical ventilation or underlying oncologic diagnosis did not differ between the groups. After adjustment for transfusion dose, there was no difference in the incremental change in platelet count between the groups; the median (interquartile range) change for ABO-identical transfusions was 28 × 109 cells/L (8-68 × 109 cells/L), for transfusions with major incompatibility 26 × 109 cells/L (7-74 × 109 cells/L), and for transfusions with minor incompatibility 54 × 109 cells/L (14-81 × 109 cells/L) (p = 0.37). No differences in count increment between the groups were noted for bleeding (p = 0.92) and nonbleeding patients (p = 0.29). There were also no differences observed between the groups for any transfusion reaction (p = 0.07). Conclusions: No differences were seen in the incremental change in platelet count nor in transfusion reactions when comparing major ABO incompatible platelet transfusions with ABO compatible transfusions in a large study of critically ill children. Studies in larger, prospectively enrolled cohorts should be performed to validate whether ABO matching for platelet transfusions in critically ill children is necessary.
AB - Objectives: To determine if transfusing ABO compatible platelets has a greater effect on incremental change in platelet count as compared to ABO incompatible platelets in critically ill children. Design: Secondary analysis of a prospective, observational study. Transfusions were classified as either ABO compatible, major incompatibility, or minor incompatibility. The primary outcome was the incremental change in platelet count. Transfusion reactions were analyzed as a secondary outcome. Setting: Eighty-two PICUs in 16 countries. Patients: Children (3 d to 16 yr old) were enrolled if they received a platelet transfusion during one of the predefined screening weeks. Interventions: None. Measurements and Main Results: Five-hundred three children were enrolled and had complete ABO information for both donor and recipient, as well as laboratory data. Three-hundred forty-two (68%) received ABO-identical platelets, 133 (26%) received platelets with major incompatibility, and 28 (6%) received platelets with minor incompatibility. Age, weight, proportion with mechanical ventilation or underlying oncologic diagnosis did not differ between the groups. After adjustment for transfusion dose, there was no difference in the incremental change in platelet count between the groups; the median (interquartile range) change for ABO-identical transfusions was 28 × 109 cells/L (8-68 × 109 cells/L), for transfusions with major incompatibility 26 × 109 cells/L (7-74 × 109 cells/L), and for transfusions with minor incompatibility 54 × 109 cells/L (14-81 × 109 cells/L) (p = 0.37). No differences in count increment between the groups were noted for bleeding (p = 0.92) and nonbleeding patients (p = 0.29). There were also no differences observed between the groups for any transfusion reaction (p = 0.07). Conclusions: No differences were seen in the incremental change in platelet count nor in transfusion reactions when comparing major ABO incompatible platelet transfusions with ABO compatible transfusions in a large study of critically ill children. Studies in larger, prospectively enrolled cohorts should be performed to validate whether ABO matching for platelet transfusions in critically ill children is necessary.
KW - ABO compatibility
KW - critical illness
KW - pediatrics
KW - platelet transfusion
UR - https://www.scopus.com/pages/publications/85061056061
U2 - 10.1097/PCC.0000000000001779
DO - 10.1097/PCC.0000000000001779
M3 - Article
C2 - 30422914
AN - SCOPUS:85061056061
SN - 1529-7535
VL - 20
SP - E61-E69
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
IS - 2
ER -