Reactions and platelet increments after transfusion of platelet concentrates in plasma or an additive solution: a prospective, randomized study

BACKGROUND: Reactions after platelet transfusions are rather common and frequently are caused by plasma constituents. In recent developments, the preparation and storage of platelet concentrates (PCs) in a platelet additive solution (PAS‐2) have been shown to result in acceptable storage conditions. A major drawback of the use of these PCs is the progressive increase of P‐selectin‐positive platelets during storage. The clinical benefit of transfusions of PCs in PAS‐2 was studied. STUDY DESIGN AND METHODS: PCs prepared from buffy coats were suspended in either plasma or PAS‐2 and stored for up to 5 days. Clinical responses were evaluated in a prospective study in 21 patients treated with intensive chemotherapy for hematologic malignancies. Eligible patients were randomly assigned to receive prophylactic transfusions of PCs prepared in either plasma or PAS‐2. Reactions and CCIs were recorded after each transfusion. RESULTS: The incidence of reactions in 12 patients given PCs in plasma (n = 192) was 12 percent. Transfusions to 9 patients of PCs in PAS‐2 (n = 132) showed a reduction in the incidence of reactions to 5.3 percent (p