Optimizing platelet transfusions: A comparative analysis of corrected count increment in platelet aphaeresis with and without platelet additive solution

Abstract: BACKGROUND: Platelet transfusions are essential in managing thrombocytopenia, commonly seen in patients undergoing chemotherapy, bone marrow transplants, and other hematologic disorders. This study focuses specifically on aphaeresis platelet transfusions. A platelet additive solution (PAS) has been proposed to enhance the quality and safety of these transfusions. This study compares the efficacy and safety of aphaeresis platelet transfusions prepared with PAS versus without PAS (Plasma). MATERIALS AND METHODS: A retrospective observational study was conducted at a tertiary care hospital in Northwestern India between January 2019 and December 2021. The study included 200 patients who received platelet transfusions. Corrected count increment (CCI) was calculated from pre and posttransfusion platelet counts measured consistently 24 h after the transfusion to ensure accuracy. Adverse reactions were monitored and documented. Statistical analyses included independent samples t -tests and additional tests for categorical variables. RESULTS: The study comprised 200 patients (PAS group: 100; non-PAS group: 100). The mean CCI was significantly higher in the PAS group (mean ± standard deviation: 15,500 ± 3500) compared to the non-PAS group (12,000 ± 4000) ( P < 0.00001). Fewer allergic reactions were observed in the PAS group (3 cases) than in the non-PAS (Plasma) group (10 cases). Patient age and weight had minimal influence on CCI. Weak correlations were observed between CCI and age (with PAS: −0.072, without PAS: −0.142) and between CCI and weight (with PAS: 0.052, without PAS: 0.239). CONCLUSION: Platelet transfusions prepared with PAS are significantly more effective, as indicated by a higher CCI, and safer, with fewer allergic reactions, compared to those prepared without PAS. The findings support the use of PAS in clinical practice to improve the outcomes of platelet transfusions. Future research should explore the long-term benefits and underlying mechanisms of PAS to further optimize transfusion practices.