(P-TS-38) Impact of amotosalen/UVA treatment for pathogen reduction in platelet concentrates on transfusion efficacy in cardiac surgery

Background/Case Studies: One of the most recent advances to improve blood safety and lower the risk of transfusion-transmitted diseases is the pathogen reduction treatment (PRT) of platelet concentrates (PCs). The characteristics of PR-treated PCs slightly differ from those of untreated PCs, and may affect transfusion outcome. This clinical research project aims to see how effective amotosalen/UVA (INTERCEPTTM Blood System) PCs are when transfused to a group of cardiac surgery patients.

Study

Design/Methods: This study examined the influence of the PRT using amotosalen‐HCl and UVA light in a population of cardiac surgery patients. We analyzed the bleeding and platelet drop post-operatively in cardiac surgery with cardiopulmonary bypass (CPB). Apheresis Platelet Concentrate (APC) or Buffy Coat Platelet Concentrate (BC-PC) with Platelet Additive Solution (PAS) stored at 22°C ± 2°C with gentle rotation and agitation for a maximum of 7 days before being released for transfusion. We selected 73 PCs after taking into account the medical exclusion criteria: 46 PCs without PRT versus 27 PCs with PRT.

Results/Findings: The decrease of patient platelet count between pre-operative and H0 (Intensive Care Unit (ICU) admission), pre-operative and H6 (6 hours after ICU admission) did not differ significantly with or without PRT. The volume of post-operative bleeding after cardiac surgery under CPB did not differ significantly regardless of whether the patient was transfused with PRT-PC or untreated PC. No difference was found in the post-operative pulmonary infections rate (pneumonia) between the groups. Moreover, independently of the use of PRT for platelets, we observed an inverse correlation between preoperative fibrinogen and bleeding at 24 hours (post-surgery). A 1 mg/L increase in fibrinogen (preoperative) is associated with a 159 mL decrease in bleeding 24 hours after the start of the surgery.

Conclusions: In post-operative cardiac surgery, the use of platelets treated with amotosalen/UVA (INTERCEPT) for pathogen reduction does not appear to affect transfusion efficacy and post-operative bleeding.

Importance of research: Amotosalen/UVA (INTERCEPT) for pathogen reduction does not appear to have an effect on the efficacy of transfusion and on postoperative bleeding.