Impact of the amotosalen/UVA process to reduce pathogens in platelet concentrates on transfusion efficiency in cardiac surgery

BACKGROUND: Pathogen reduction treatment (PRT) of platelet concentrates (PC) is one of the most recent advances in improving blood safety and lowering the risk of transfusion-transmitted diseases. The characteristics of PR-treated PC differ slightly from those of untreated PC and may affect transfusion outcomes. We established how effective PRT methods, (INTERCEPT™ Blood System) PC are when transfused to cardiac surgery patients. MATERIALS AND METHODS: This study examined the influence of PRT using amotosalen and UVA light in a population of cardiac surgery patients. We analysed bleeding and platelet drop following cardiopulmonary bypass (CPB) surgery. We selected 73 patients after considering the medical exclusion criteria: 46 patients transfused with untreated platelet concentrate versus 27 patients transfused with PRT-treated platelet concentrate. RESULTS: Data analysis concerns the readout after the first platelet concentrate transfusion. The decrease in patient platelet count between pre-operative and H0 [Intensive Care Unit (ICU) admission], and pre-operative and H6 post-surgery did not differ significantly with or without PRT. The volume of postoperative bleeding after CPB surgery did not differ significantly regardless of whether the patient was transfused with PRT-PC or untreated PC. No difference was documented between the groups in terms of postoperative pulmonary infection rate. Regardless of the use of platelet PRT, among the factors associated with bleeding, only Fg level was independently and significantly associated. A 1mg/L increase in fibrinogen (pre-operative) is associated with a 159mL decrease in bleeding 24hours post-surgery. DISCUSSION: In postoperative cardiac surgery, the use of platelets treated with amotosalen/UVA for pathogen reduction does not appear to affect transfusion effectiveness and postoperative bleeding.