Effect of single donor platelet versus random donor platelet concentrates in thrombocytopenic patients at SKIMS Blood Bank-A hospital based study.

Résumé

BACKGROUND: Platelet transfusion plays a key role in thrombocytopenic patients. Platelet rich plasma-platelet concentrate (PRP-PC) and apheresis platelet concentrate was prepared and their therapeutic efficacy was assessed in thrombocytopenic patients.

OBJECTIVES:

1. To study need for platelet transfusion in thrombocytopenic patients.
2. To find whether RDPs or SDPs are better for post transfusion recovery.

PARTICIPANTS: 60 thrombocytopenic patients- 30 received SDP and 30 RDP.

STUDY DESIGN: A prospective observational study over a period of 1 year.

METHOD: Post platelet transfusion efficacy was assessed at 1hour and 24hours by Corrected count increment (CCI) and Percentage platelet recovery (PPR). Student’s independent t-test or Mann-Whitney U-test was employed for comparing continuous variables and Chi-square or Fisher’s exact test for categorical variables, whichever was feasible. p-value < 0.05 was considered statistically significant.

RESULTS: Mean platelet dose of SDP(n=30) and RDP(n=30) was 3.47±0.78×10¹¹/µl and 2.37±0.53×10¹¹/µl respectively. Mean platelet increment(PI) of SDP at 1hour and 24hours was 30.33±6.82×10¹¹/µl and 23.17±7.01×10¹¹/µl  respectively while that of RDP was 18.43±2.66×10¹¹/µl and 11.87±2.11×10¹¹/µl. Mean CCI of SDP was 14.73±8.32×10¹¹/µl at 1hour and 11.24±7.13×10¹¹/µl at 24hours and that of RDP was 12.41±6.86×10¹¹/µl and 8.47±6.56×10¹¹/µl respectively. Mean PPR at 1hour and 24hours for SDP was 37.84±14.26% and 27.91±13.03% and of RDP was 32.47±11.08% and 22.74±9.86% respectively.

CONCLUSION: Post transfusion increment is significantly higher in patients who received SDP as compared to RDP, but the CCI and PPR is comparable in both groups of patients.

IMPLICATION: SDP is better than RDP when considering numbers of donors exposed to patient, leucoreduction and  reducing allo-immunization.