Nellis, ME;
Goel, R;
Karam, O;
Cushing, MM;
Davis, PJ;
Steiner, ME;
Tucci, M;
Stanworth, SJ;
Spinella, PC;
Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Ne, ;
et al.
Nellis, ME; Goel, R; Karam, O; Cushing, MM; Davis, PJ; Steiner, ME; Tucci, M; Stanworth, SJ; Spinella, PC; Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Ne; P3T Investigators
(2019)
Effects of ABO Matching of Platelet Transfusions in Critically Ill Children.
Pediatr Crit Care Med, 20 (2).
e61-e69.
ISSN 1529-7535
https://doi.org/10.1097/PCC.0000000000001779
SGUL Authors: Prince, Nick James
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Abstract
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 × 10 cells/L (8-68 × 10 cells/L), for transfusions with major incompatibility 26 × 10 cells/L (7-74 × 10 cells/L), and for transfusions with minor incompatibility 54 × 10 cells/L (14-81 × 10 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.
Item Type: |
Article
|
Additional Information: |
This is a non-final version of an article published in final form in Nellis, ME; Goel, R; Karam, O; Cushing, MM; Davis, PJ; Steiner, ME; Tucci, M; Stanworth, SJ; Spinella, PC; Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Ne, ; et al. (2019) Effects of ABO Matching of Platelet Transfusions in Critically Ill Children. Pediatr Crit Care Med, 20 (2). e61-e69. |
Keywords: |
Adolescent, Blood Grouping and Crossmatching, Child, Child, Preschool, Critical Illness, Female, Humans, Infant, Infant, Newborn, Intensive Care Units, Pediatric, Male, Platelet Count, Platelet Transfusion, Prospective Studies, Transfusion Reaction, Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, Pediatric Critical Care Blood Research Network (BloodNet), and the P3T Investigators, P3T Investigators, Humans, Critical Illness, Platelet Count, Blood Grouping and Crossmatching, Platelet Transfusion, Prospective Studies, Adolescent, Child, Child, Preschool, Infant, Infant, Newborn, Intensive Care Units, Pediatric, Female, Male, Transfusion Reaction, 1110 Nursing, 1114 Paediatrics and Reproductive Medicine, Pediatrics |
SGUL Research Institute / Research Centre: |
Academic Structure > Institute of Medical & Biomedical Education (IMBE) |
Journal or Publication Title: |
Pediatr Crit Care Med |
ISSN: |
1529-7535 |
Language: |
eng |
Dates: |
Date | Event |
---|
February 2019 | Published |
|
Projects: |
Project ID | Funder | Funder ID |
---|
K08 GM129763 | NIGMS NIH HHS | UNSPECIFIED | P30 CA008748 | NCI NIH HHS | UNSPECIFIED | UL1 TR000457 | NCATS NIH HHS | UNSPECIFIED | UL1 TR002384 | NCATS NIH HHS | UNSPECIFIED |
|
PubMed ID: |
30422914 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/112633 |
Publisher's version: |
https://doi.org/10.1097/PCC.0000000000001779 |
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