Goodnough L T, Riddell J, Lazarus H, Chafel T L, Prince G, Hendrix D, Yomtovian R
Department of Medicine, Case Western Reserve University, Cleveland, Ohio.
Vox Sang. 1993;65(2):103-7. doi: 10.1111/j.1423-0410.1993.tb02124.x.
To determine the impact of platelet leukodepletion by filtration on the overall prevalence of reported transfusion reactions associated with platelet concentrates, we audited platelet transfusion reactions after infusion of platelet concentrates reported at University Hospitals of Cleveland over 6 months before (interval 1, July 1, 1989 to December 31, 1989) and after (interval 2, July 1, 1990 to December 31, 1990) implementation of the Pall PL 50 filter on our adult Hematology-Oncology inpatient unit (Division 60). Thirty-two (1.7%) of 1,901 random, pooled platelet transfusion events resulted in blood bank transfusion reaction workups in interval 1, compared to 90 (5.3%) of 1,704 in interval 2 (p < 0.001). The Division 60 service accounted for more of our hospital-wide platelet reactions after implementation of the filter in interval 2 (84%) than before filtration in interval 1 (42%), p = 0.002. The prevalence of reaction workups for Division 60 was 0.6% for interval 1, compared to 4.3% for interval 2 (p < 0.001). No differences were found between interval 1 and interval 2 for the rate of discontinuation of platelet transfusion (36 vs. 32%, p = 0.14), rate of premedication for platelet transfusion (72 vs. 65%, p = 0.6), percentage of direct antiglobulin test-positive reactions (17 vs. 5.4%, p = 0.09), percentage showing icteric/hemolyzed serum (15 vs. 4.4%, p = 0.09), or reactions believed to be due to red blood cell incompatibility (8.8 vs. 1.1%, p = 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)
为了确定通过过滤去除血小板中的白细胞对与血小板浓缩物相关的报告输血反应总体发生率的影响，我们审核了在克利夫兰大学医院我们成人血液肿瘤住院部（60病区）实施颇尔PL 50过滤器之前（时间段1，1989年7月1日至1989年12月31日）和之后（时间段2，1990年7月1日至1990年12月31日）输注血小板浓缩物后报告的血小板输血反应。在时间段1，1901次随机混合的血小板输血事件中有32次（1.7%）导致血库进行输血反应检查，而在时间段2，1704次中有90次（5.3%）（p<0.001）。在时间段2过滤器实施后，60病区的输血反应在全院范围内所占比例（84%）高于时间段1过滤前（42%），p = 0.002。60病区在时间段1反应检查的发生率为0.6%，而时间段2为4.3%（p<0.001）。在血小板输血中断率（36%对32%，p = 0.14）、血小板输血前用药率（72%对65%，p = 0.6）、直接抗球蛋白试验阳性反应百分比（17%对5.4%，p = 0.09）、出现黄疸/溶血血清的百分比（15%对4.4%，p = 0.09）或被认为是由于红细胞不相容引起的反应（8.8%对1.1%，p = 0.1）方面，时间段1和时间段2之间未发现差异。（摘要截断于250字）
