Department of Anesthesia and Intensive Care, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Institut National de Transfusion Sanguine, Paris, France.
Transfusion. 2020 Mar;60(3):507-512. doi: 10.1111/trf.15275. Epub 2019 Mar 25.
Among labile blood products, platelet concentrates (PCs) are the leading cause of hypersensitivity transfusion reactions (HTRs). These reactions often lead to interruption of PC transfusion and can result in a prolonged transfusion process leading to significant morbidity and use of premedication and close monitoring for patients with a history of allergic transfusion reactions. The French hemovigilance database is one of the largest standardized databases providing information on HTRs following administration of labile blood products. In this study, we analyzed this database to assess the relative risk of HTR for each type of PC.
HTRs following PC transfusion were retrospectively extracted from the e-Fit Hemovigilance database of the French National Agency for Medicines and Health Products Safety (ANSM). Frequencies were calculated using the number of specific PCs transfused.
Between 2008 and 2014, the overall estimated incidence of HTRs following PC administration was calculated at 232 HTRs per 100,000 PCs transfused. The rate of HTRs was significantly higher with apheresis PC (337/100,000) than with buffy-coat PC (94/100,000). Platelets in additive solutions (PAS) were associated with a significantly lower frequency of HTRs when compared with PCs in native plasma. Amotosalen/UVA- PCs (APCs and BCPCs) which are always in PAS in France, exhibited the lowest frequency of HTRs when compared with their corresponding PCs in native plasma or in PAS (p < 10 in all comparisons).
Our results showed that the type of PC and its processing may have an impact on the risk of HTR.
在不稳定血液制品中，血小板浓缩物（PC）是引起过敏输血反应（HTR）的主要原因。这些反应通常会导致 PC 输血中断，并可能导致输血过程延长，从而给患者带来显著的发病率，并需要对有过敏输血反应史的患者进行药物预防和密切监测。法国血液监测数据库是提供不稳定血液制品给药后 HTR 信息的最大标准化数据库之一。在本研究中，我们分析了该数据库，以评估每种 PC 发生 HTR 的相对风险。
从法国国家药品和保健品安全局（ANSM）的 e-Fit 血液监测数据库中回顾性提取 PC 输血后发生的 HTR。使用特定 PC 输注数量计算频率。
2008 年至 2014 年期间，每输注 100,000 个 PC 估计发生 HTR 的总体发生率为 232 例。与手工制备 PC（337/100,000）相比，单采 PC（APCs 和 BCPCs）的 HTR 发生率明显更高（94/100,000）。与在天然血浆中的 PC 相比，添加溶液（PAS）中的血小板与 HTR 频率显著降低相关。在法国，始终在 PAS 中的 Amotosalen/UVA-PC（APCs 和 BCPCs）与它们在天然血浆或 PAS 中的相应 PC 相比，HTR 发生率最低（所有比较均为 p<10）。
我们的结果表明，PC 的类型及其处理可能会影响 HTR 的风险。
