The effect of variation in donor platelet function on transfusion outcome: a semirandomized controlled trial

Autor: Charlotte Llewelyn, Alison Deary, Theodora Foukaneli, Brennan C Kahan, Nina Herbert, Stephen F. Garner, Lorna M. Williamson, Thomas R. Godec, Rebecca Cardigan, Lekha Bakrania, Willem H. Ouwehand, Anne M. Kelly
Rok vydání: 2017
Předmět:
0301 basic medicine
Adult
Blood Platelets
Male
medicine.medical_specialty
Platelet Function Tests
Anemia
Immunology
Hemoglobinuria
Paroxysmal
Hemorrhage
Platelet Transfusion
030204 cardiovascular system & hematology
Single Center
Biochemistry
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Double-Blind Method
law
Internal medicine
medicine
Clinical endpoint
Humans
Platelet
Platelet Activating Factor
Bone Marrow Diseases
Aged
Intention-to-treat analysis
business.industry
Platelet Count
Bone marrow failure
Anemia
Aplastic
Cell Biology
Hematology
Bone Marrow Failure Disorders
Middle Aged
medicine.disease
Platelet Activation
Thrombocytopenia
Tissue Donors
Surgery
Intention to Treat Analysis
030104 developmental biology
Platelet transfusion
Female
business
Zdroj: Blood. 130(2)
ISSN: 1528-0020
Popis: The effect of variation in platelet function in platelet donors on patient outcome following platelet transfusion is unknown. This trial assessed the hypothesis that platelets collected from donors with highly responsive platelets to agonists in vitro assessed by flow cytometry (high-responder donors) are cleared more quickly from the circulation than those from low-responder donors, resulting in lower platelet count increments following transfusion. This parallel group, semirandomized double-blinded trial was conducted in a single center in the United Kingdom. Eligible patients were those 16 or older with thrombocytopenia secondary to bone marrow failure, requiring prophylactic platelet transfusion. Patients were randomly assigned to receive a platelet donation from a high- or low-responder donor when both were available, or when only 1 type of platelet was available, patients received that. Participants, investigators, and those assessing outcomes were masked to group assignment. The primary end point was the platelet count increment 10 to 90 minutes following transfusion. Analysis was by intention to treat. Fifty-one patients were assigned to receive platelets from low-responder donors, and 49 from high-responder donors (47 of which were randomized and 53 nonrandomized). There was no significant difference in platelet count increment 10 to 90 minutes following transfusion in patients receiving platelets from high-responder (mean, 21.0 × 109/L; 95% confidence interval [CI], 4.9-37.2) or low-responder (mean, 23.3 × 109/L; 95% CI, 7.8-38.9) donors (mean difference, 2.3; 95% CI, -1.1 to 5.7; P = .18). These results support the current policy of not selecting platelet donors on the basis of platelet function for prophylactic platelet transfusion.
Databáze: OpenAIRE
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