Effects of ABO matching of platelet transfusions in critically III children

on behalf of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) network, Pediatric Critical Care Blood Research Network (BloodNet); The PT Investigators

doi:10.1097/PCC.0000000000001779

Effects of ABO matching of platelet transfusions in critically III children

on behalf of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) network, Pediatric Critical Care Blood Research Network (BloodNet), The PT Investigators

Pediatrics - Hematology

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

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 × 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.

Original language	English (US)
Pages (from-to)	E61-E69
Journal	Pediatric Critical Care Medicine
Volume	20
Issue number	2
DOIs	https://doi.org/10.1097/PCC.0000000000001779
State	Published - Feb 1 2019

Bibliographical note

Funding Information:
1Pediatric Critical Care Medicine, Department of Pediatrics, NY Presbyte-rian Hospital – Weill Cornell Medicine, New York, NY. 2Division of Transfusion Medicine, Department of Pathology, Johns Hop-kins University, Baltimore, MD. 3Simmons Cancer Institute at SIU School of Medicine, Springfield, IL. 4Division of Pediatric Critical Care Medicine, Department of Pediatrics, Children’s Hospital of Richmond at VCU, Richmond, VA. 5Department of Pathology – Weill Cornell Medicine, New York, NY. 6Paediatric Intensive Care Unit, Department of Pediatrics, Bristol Royal Hospital for Children, Bristol, United Kingdom. 7Divisions of Pediatric Critical Care and Pediatric Hematology/Oncology, Department of Pediatrics, University of Minnesota, Minneapolis, MN. 8Pediatric Intensive Care Unit, Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada. 9Transfusion Medicine, NHS Blood and Transplant, Oxford, United Kingdom. 10Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom. 11Radcliffe Department of Medicine, University of Oxford, and Oxford BRC Haematology Theme, Oxford United Kingdom. 12Department of Pediatrics, Division Critical Care, Washington University in St Louis, St Louis, MO. P3T Investigators are listed in the Acknowledgments. Supported, in part, by funds from the Clinical Translational Science Center, National Center for Advancing Translational Sciences grant number UL1-TR000457. Drs. Cushing and Spinella received funding from Cerus Corporation. The

Funding Information:
Supported, in part, by funds from the Clinical Translational Science Center, National Center for Advancing Translational Sciences grant number UL1-TR000457.

Publisher Copyright:
© 2018 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

Keywords

ABO compatibility
critical illness
pediatrics
platelet transfusion

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10.1097/PCC.0000000000001779

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709973

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Effects of ABO matching of platelet transfusions in critically III children. / on behalf of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) network, Pediatric Critical Care Blood Research Network (BloodNet); The PT Investigators.
In: Pediatric Critical Care Medicine, Vol. 20, No. 2, 01.02.2019, p. E61-E69.

Research output: Contribution to journal › Article › peer-review

@article{7fbb01ee543442f182b6e41e2dd33049,

title = "Effects of ABO matching of platelet transfusions in critically III children",

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 × 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.",

keywords = "ABO compatibility, critical illness, pediatrics, platelet transfusion",

author = "{on behalf of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) network, Pediatric Critical Care Blood Research Network (BloodNet)} and {The PT Investigators} and Nellis, {Marianne E.} and Ruchika Goel and Oliver Karam and Cushing, {Melissa M.} and Davis, {Peter J.} and Steiner, {Marie E.} and Marisa Tucci and Stanworth, {Simon J.} and Spinella, {Philip C.} and Warwick Butt and Carmel Delzoppo and Simon Erickson and Elizabeth Croston and Samantha Barr and Elena Cavazzoni and {de Jaeger}, Annick and French, {Mary Ellen} and Marion Ropars and Lucy Clayton and Srinivas Murthy and Gordon Krahn and Dong Qu and Yi Hui and Mathias Johansen and Jensen, {Anne Mette Baek} and Jarnvig, {Inge Lise} and Ditte Strange and Muralidharan Jayashree and Mounika Reddy and Jhuma Sankar and {Vijay Kumar}, U. and Rakesh Lodha and Lerner, {Reut Kassif} and Gideon Paret and Ofer Schiller and Eran Shostak and Ovadia Dagan and Yuval Cavari and Fabrizio Chiusolo and Annagrazia Cillis and Anna Camporesi and Martin Kneyber and Otter, {Suzan Cochiusden} and {Van Hemeldonck}, Ellen and John Beca and Claire Sherring and Miriam Rea and Clara Abadesso and Marta Moniz and Saleh Alshehri",

note = "Funding Information: 1Pediatric Critical Care Medicine, Department of Pediatrics, NY Presbyte-rian Hospital – Weill Cornell Medicine, New York, NY. 2Division of Transfusion Medicine, Department of Pathology, Johns Hop-kins University, Baltimore, MD. 3Simmons Cancer Institute at SIU School of Medicine, Springfield, IL. 4Division of Pediatric Critical Care Medicine, Department of Pediatrics, Children{\textquoteright}s Hospital of Richmond at VCU, Richmond, VA. 5Department of Pathology – Weill Cornell Medicine, New York, NY. 6Paediatric Intensive Care Unit, Department of Pediatrics, Bristol Royal Hospital for Children, Bristol, United Kingdom. 7Divisions of Pediatric Critical Care and Pediatric Hematology/Oncology, Department of Pediatrics, University of Minnesota, Minneapolis, MN. 8Pediatric Intensive Care Unit, Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada. 9Transfusion Medicine, NHS Blood and Transplant, Oxford, United Kingdom. 10Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom. 11Radcliffe Department of Medicine, University of Oxford, and Oxford BRC Haematology Theme, Oxford United Kingdom. 12Department of Pediatrics, Division Critical Care, Washington University in St Louis, St Louis, MO. P3T Investigators are listed in the Acknowledgments. Supported, in part, by funds from the Clinical Translational Science Center, National Center for Advancing Translational Sciences grant number UL1-TR000457. Drs. Cushing and Spinella received funding from Cerus Corporation. The Funding Information: Supported, in part, by funds from the Clinical Translational Science Center, National Center for Advancing Translational Sciences grant number UL1-TR000457. Publisher Copyright: {\textcopyright} 2018 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.",

year = "2019",

month = feb,

day = "1",

doi = "10.1097/PCC.0000000000001779",

language = "English (US)",

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pages = "E61--E69",

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TY - JOUR

T1 - Effects of ABO matching of platelet transfusions in critically III children

AU - on behalf of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) network, Pediatric Critical Care Blood Research Network (BloodNet)

AU - The PT 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 - 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 - Vijay Kumar, U.

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 Cochiusden

AU - Van Hemeldonck, Ellen

AU - Beca, John

AU - Sherring, Claire

AU - Rea, Miriam

AU - Abadesso, Clara

AU - Moniz, Marta

AU - Alshehri, Saleh

N1 - Funding Information: 1Pediatric Critical Care Medicine, Department of Pediatrics, NY Presbyte-rian Hospital – Weill Cornell Medicine, New York, NY. 2Division of Transfusion Medicine, Department of Pathology, Johns Hop-kins University, Baltimore, MD. 3Simmons Cancer Institute at SIU School of Medicine, Springfield, IL. 4Division of Pediatric Critical Care Medicine, Department of Pediatrics, Children’s Hospital of Richmond at VCU, Richmond, VA. 5Department of Pathology – Weill Cornell Medicine, New York, NY. 6Paediatric Intensive Care Unit, Department of Pediatrics, Bristol Royal Hospital for Children, Bristol, United Kingdom. 7Divisions of Pediatric Critical Care and Pediatric Hematology/Oncology, Department of Pediatrics, University of Minnesota, Minneapolis, MN. 8Pediatric Intensive Care Unit, Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada. 9Transfusion Medicine, NHS Blood and Transplant, Oxford, United Kingdom. 10Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom. 11Radcliffe Department of Medicine, University of Oxford, and Oxford BRC Haematology Theme, Oxford United Kingdom. 12Department of Pediatrics, Division Critical Care, Washington University in St Louis, St Louis, MO. P3T Investigators are listed in the Acknowledgments. Supported, in part, by funds from the Clinical Translational Science Center, National Center for Advancing Translational Sciences grant number UL1-TR000457. Drs. Cushing and Spinella received funding from Cerus Corporation. The Funding Information: Supported, in part, by funds from the Clinical Translational Science Center, National Center for Advancing Translational Sciences grant number UL1-TR000457. 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

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JO - Pediatric Critical Care Medicine

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Effects of ABO matching of platelet transfusions in critically III children

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