Comparison of the effectiveness of clinical use of different types of donor platelet concentrates in adult cardiac surgery patients

Cardiac surgery patients often require allogeneic platelet transfusions. The blood service produces several types of donor platelet concentrates (РС), the methods of obtaining and additional processing of which directly affect the functional state of the cells and their clinical effectiveness. Pathogen reduction РC reduces the risk of transmission of infections (bacteria, viruses), but its effect on clinical effectiveness in cardiac surgery has not been sufficiently studied. Currently, there are no large randomized studies on this topic. Purpose of the study. To compare the effectiveness of the clinical use of different types of donor platelet concentrates in adult cardiac surgery patients. Material and methods. A retrospective randomized controlled trial was conducted. Adult cardiac surgery patients who received one or more РC units were eligible for inclusion. Exclusion criteria included patients with the presence of factors that could affect post-transfusion platelet growth: sepsis, febrile fever, РC transfusion resistance. The primary endpoint was an increase in the number of circulating peripheral blood platelets at 1 and 24 hours. The secondary endpoint was the need for repeat transfusions. The t test was used to compare continuous variables. Results. The study included 162 patients who were divided into groups that received either pathogen-reduced (group 1) or leukoreduced (group 2). There were no statistically significant differences between the groups. Discussion. In both groups, the number of platelets after 24 hours exceeded the initial level. However, the absolute increase in platelet count after 1 and 24 hours in group 1 was lower by 17 and 15%, respectively. In order to take into account the individual characteristics of patients, the method of adjusted platelet growth was used. After 1 hour and 24 hours indicated the effectiveness of replacement therapy, but in the first group it was lower than in the second. Lower platelet growth rates in the first group were not accompanied by a shortening of the interval between transfusions. Conclusions. Pathogen-reduced РC transfusions are associated with lower APT and SPT at 1 and 24 hours. However, a decrease in these indicators does not lead to a decrease in the interval between transfusions and an increase in the frequency of transfusions. The results obtained above may indicate equal clinical effectiveness of both types of РC.

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