Hemostatic efficacy of pathogen-reduced platelets in children undergoing cardiopulmonary bypass.

TitleHemostatic efficacy of pathogen-reduced platelets in children undergoing cardiopulmonary bypass.
Publication TypeJournal Article
Year of Publication2022
AuthorsHsien S, Dayton JD, Chen D, Stock A, Bacha E, Cushing MM, Nellis ME
Date Published2022 Feb
KeywordsBlood Platelets, Cardiopulmonary Bypass, Child, Hemostasis, Hemostatics, Humans, Postoperative Hemorrhage, Retrospective Studies, Thrombocytopenia

BACKGROUND: Pediatric patients undergoing cardiopulmonary bypass (CPB) often require blood component transfusions. Pathogen-reduction (PR) of platelets reduces the risk of microbial contamination; however, its effect on hemostatic efficacy in this population is unclear. This study sought to characterize the hemostatic efficacy of PR platelets in children undergoing CPB.

STUDY DESIGN AND METHODS: We performed a retrospective chart review of patients admitted to a pediatric intensive care unit following CPB surgery from 2015 to 2019. Demographic data, validated scoring of repair complexity, products received, and outcomes were compared. The primary outcome was postoperative chest tube bleeding.

RESULTS: A total of 140 patients were enrolled. The majority of surgeries (124/140) were Risk Adjustment for Congenital Heart Surgery (RACHS) 1-3 repairs. Seventy-four percent of patients (104/140) received only standard platelets whereas 26% (36/140) received PR platelets. There were no differences between the groups in the age (p = .90), sex (p = .20) or RACHS score (p = .06). Postoperatively, there was no difference in the median chest tube output for 1 h (p = .27), 2 h (p = .26), 4 h (p = .09), 8 h (p = .16), or for the first 24 h following surgery (p = .23) in patients who received standard versus PR platelets. There was also no difference in receipt of platelets (p = .18), cell saver (p = .79), or cryoprecipitate (p = .28).

CONCLUSION: Patients receiving PR platelets did not have more blood loss or require more transfusions than those who received standard platelets. This suggests that PR platelets may provide acceptable hemostasis with the additional benefits of reduced risk of microbial contamination in pediatric patients undergoing CPB.

Alternate JournalTransfusion
PubMed ID34904250
PubMed Central IDPMC8837684
Grant ListUL1 TR000457 / TR / NCATS NIH HHS / United States
UL1 TR002384 / TR / NCATS NIH HHS / United States
Related Faculty: 
Melissa Cushing, M.D.

Pathology & Laboratory Medicine 1300 York Avenue New York, NY 10065 Phone: (212) 746-6464
Surgical Pathology: (212) 746-2700