Use and safety of riboflavin and UV light‐treated platelet transfusions in children over a five‐year period: focusing on neonates

BACKGROUND There are very few published reports about the use and safety of pathogen reduction technology (PRT) based on riboflavin and UV light for platelet (PLT) transfusion in children. STUDY DESIGN AND METHODS A two‐part study was conducted: 1) a study investigating the safety of PLTs treated with riboflavin and UV light‐PRT transfused to 379 children and 1,980 adults over a 5‐year period; 2) an observational study evaluating the efficacy of PLT use in 132 neonates transfused with PRT‐treated PLT compared with 99 neonates receiving standard PLTs over two 5‐year periods. RESULTS The rate of adverse reactions related to transfusions with PRT‐treated PLTs was found to be slightly higher in adults than in children, although not statistically significant (0.19% vs. 0.12%; p = 0.85). All PLT transfusion events in children were mild. From 2013 to 2017, 379 children received 4,236 riboflavin and UV light‐treated PLTs. Hemato‐oncology patients received the most PLT transfusions (61.2%), followed by critically ill children in the Pediatric Intensive Care Unit (PICU) (24.6%), and neonates in the Neonatal Intensive Care Unit (NICU) (10.5%). A significant increase in PLT transfusions was found in 132 neonates transfused with 458 PRT‐treated PLTs compared with 99 neonates receiving 176 standard PLTs, measuring PLT use/patient (p = 0.031) and total PLT dose/patient (p = 0.041). CONCLUSIONS Riboflavin and UV light‐based PRT for PLTs seems to be safe for children. Neonates required a higher number of PLT transfusions when these were PRT‐treated rather than standard. A long‐term follow‐up for chronically transfused children and randomized clinical trials are needed.