Background
Methods
Eligibility criteria, information sources and search strategy
Data collection process and study quality assessment
Results
Study | Population | Study design | PLT characteristics and maximum storage duration | Primary outcome | Secondary outcome | Analyses/comparator | Main results |
---|---|---|---|---|---|---|---|
Welsby et al. [23] | Cardiac surgery, 2578 patients | Retrospective single centre | Leucoreduced Apheresis 5 days | 30-day mortality or hospital stay > 10 days | Infections Survival up to 5 years RBC requirement | All patients Patients with only one unit Oldest PLT transfused | No association |
Inaba et al. [21] | Trauma, 381 patients | Retrospective two-centre | Apheresis 5 days | Mortality | Sepsis ARDS AKI Liver failure ICU and hospital LOS RBC requirement | Patients with only PLTs stored for ≤ 3 days, 4 days and 5 days | No association with mortality More sepsis in the group transfused with PLTs stored for 5 days |
Juffermans et al. [24] | ICU, 134 patients | Retrospective single centre | Leucoreduced WBD, buffy coat derived
a
| Nosocomial infections | – | Number of PLTs > 4 days | No association |
Juffermans et al. [25] | Trauma, 196 patients | Retrospective single centre | Leucoreduced WBD, buffy coat derived
a
| Nosocomial infections | – | Number of PLTs > 4 days | No association |
Flint et al. [22] | ICU, 1430 patients | Retrospective two-centre | Leucoreduced Apheresis and WBD, buffy coat derived 5 days | Mortality | Blood stream infections and bacteriuria RBC requirement | All patients and patients receiving only one PLY unit Oldest PLTs, freshest PLTs and mean age of all PLTs | No association |
Study | Population | Study design | PLT characteristics and maximum storage duration | Primary outcome | Secondary outcome | Analysis/comparator | Main results |
---|---|---|---|---|---|---|---|
Van Rhenen et al. [35] | Haematology Prophylactic PLTs 103 patients | Propsective observational study for the review outcomea | Leucoreduced WBD, buffy coat derived 5 days | 1-h CCI | 24-h CCI | Up to 5 days | Association between PLT storage time and 1 and 24-h CCI |
Dijkstra-Tiekstra et al. [28] | Haematology Prophylactic PLTs 70 patients, 389 transfusions | Prospective observational single centre | Leucoreduced, WBD, buffy coat derived 7 days | 1-h CI ≥ 10 1-h CCI ≥ 7.5 | 1-h CCI | 2, 3, 4, 5, 6 and 7 days | No difference between 5 and 7 days of storage; PLTs stored for 2 days had higher 1-h CCI than PLTs stored for 7 days |
Slichter et al. [12] | Haematology 528 patients Prophylactic transfusion | Post hoc analysis of a randomised trial | Apheresis and WBD, plasma rich preparation 5 days | 1- and 24-h CCI | Time to next transfusion Refractoriness | 2, 3, 4 and 5 days Analysis per transfusion | PLTs stored less than 48 h were associated with better 1- and 24-h CCI and s longer time to next transfusion |
Akkok et al. [31] | Haematology 77 patients Prophylactic and therapeutic transfusions | Prospective observational, two-centre | Leucoreduced Apheresis and WBD, buffy coat derived 6.5 days | 1-h CCI | 18–24 h CCI Time to next transfusion | Up to 6.5 days | Decrease in 1- and 24-h CCI and time to next transfusion when storage time increased |
Heim et al. [36] | Haematology 672 patients Prophylactic transfusion | Prospective observational | Apheresis 5 days | 1- and 24-h CCI | TRAE | Up to 5 days | PLTs stored for ≥ 3 days were associated with a lower CCI |
Diedrich et al. [27] | Haematology 60 patients Prophylactic transfusion | Double blind randomised, single centre | Leucoreduced Blood group O irradiated WBD, buffy coat derived 7 days | 1- and 24-h CCI | Time to next PLT transfusion Bleeding | Storage duration:1 to 5 days versus 6 to 7 days Mean storage 2.9 days vs 6.6 days | Higher CCI and longer time to next transfusion in the group “fresher PLT” |
Kerkhoffs et al. [32] | Haemato-oncology 278 patients | Prospective multicentre observational study for the review outcomesa | Leucoreduced, WBD, buffy coat derived 7 days | 1-h CCI | 24-h CCI RBC number Bleeding Time to next transfusion | Up to 7 days | Storage time was associated with 1- and 24-h CCI but not with bleeding |
Triulzi et al. [34] | Haematology 1231 patients | Post hoc analysis of a multicentre RCT | Apheresis or WBD plasma rich preparation Leucoreduced 5 days | Clinical bleeding (time from first transfusion to first ≥ grade 2 bleeding) | Absolute PLT CI and CCI 4, 16 and 24 h | Age of PLTs of the first transfusion | No association between PLT storage duration and bleeding PLTs stored for ≤ 3 days were associated with higher CCI and PLT CI |
Heuft et al. [33] | Haematology 77 patients 526 prophylactic transfusions | Retrospective single centre | Apheresis PLTs 5 days | 24-h CCI | Time to next transfusion RBC number Bleeding | Max 4 days versus 3 days Subgroup with only one transfusion/day, without RBC transfusion | Fresher PLTs were associated with higher CCI and less bleeding |
Dijkstra-Tiekstra et al. [29] | Onco-haematology 93 patients with only one PLT/day 389 transfusions | Prospective observational, three-centre | WBD, buffy coat derived 7 days | 1- and 24-h CCI | – | 2, 3, 4, 5, 6, 7 days | No association |
MacLennan et al., [26] | Haematology 122 patients | Crossover blocked randomised trial; 2 to 5 days versus 5 to 7 days | Apheresis and WBD buffy coat derived, leucoreduced 7 days | CCI > 4.5 between 8 to 24 h | CCI Time to next transfusion Bleeding events (WHO classification) | Mean age 3.8 days (SD1.0) versus 6.4 (0.5) days | No effect of the age of PLTs on primary outcome and bleeding |
Kaufman et al. [4] | Haematology 1102 patients, 5034 transfusions | Post hoc analysis of a multicentre RCT | Apheresis or WBD plasma rich preparation, leukoreduced 5 days | TRAE | TRAE considered separately | 0–2 days, 3 days, 4 days versus 5 days as reference | No association |
Kaplan et al. [30] | Haematology 146 patients, 242 transfusions | Retrospective single centre study | WBD riboflavin based PRTs 7 days | 24-h PLT CI | TRAE | Up to 5 days versus 6–7 days | No association |
PLT storage and critically ill patients
Mortality
Length of stay
Infection and morbidity
RBC requirement
Study | 1–24 h CCI | Time to next transfusion (days) |
---|---|---|
Van Rhenen et al. [35] | Decrease in CCI with increased storage time | – |
Dijkstra-Tiekstra et al. [28] | Decrease in CCI with increased storage time | – |
Slichter et al. [12] | Decrease in CCI with increased storage time | – |
Akkok et al. [31] | Decrease in CCI with increased storage time | Decreased time to next transfusion with decrease in storage time |
Heim et al. [36] | Decrease in CCI with increased storage time (hazard ratio 1.201, 95% confidence interval 1.065–1.354, p = 0.003) | – |
Diedrich et al. [27] | Decrease in CCI with increased storage time (mean 5.4 ± 4.1 versus 2.6 ± 2.6, p < 0.001) | Decreased time to next transfusion with decrease in storage time (mean time 2.2 ± 1.1 days versus 1.6 ± 0.8 days, p < 0.005) |
Kerkhoffs et al. [32] | Decrease in CCI with increased storage time | – |
Triulzi et al. [34] | Decrease in CCI with increased storage time | No association |
Heuft et al. [33] | Decrease in CCI with increased storage time (median 8.3 [IQR 3.9–13.1] versus 3.5 × [IQR 1.5 10.0], p < 0.01) | Decreased time to next transfusion with decrease in storage time (median 1.1 day versus 2 days, p < 0.001) |
Dijkstra-Tiekstra et al. [29] | Decrease in CCI with increased storage time | – |
MacLennan et al., [26] | No association | No association |
Kaplan et al. [30] | No association | – |
PLT storage and haematology patients
Study | Allocation concealment | Random sequence generation | Blinding (participant, physician) | Blinding (outcome) | Incomplete outcome data | Selective reporting | Other |
---|---|---|---|---|---|---|---|
Diedrich et al. [27] | Low risk | Unclear | Low risk | Low risk | Low risk | Low risk | Similar number excluded due to wrong PLT storage time each arm |
MacLennan et al. [26] | Low risk | Low risk | Unclear risk | Low risk | Low risk | Low risk | Off protocol transfusion |
Study | Bias due to confounding | Selection bias | Bias due to classification of interventions | Deviation from protocol | Missing data | Measurement of outcomes | Selective reporting | Overall risk of bias |
---|---|---|---|---|---|---|---|---|
Outcome: mortality | ||||||||
Welsby et al. [23] | Moderate risk | Low risk | Low risk | Low risk | Low risk | Low risk | Moderate risk | Moderate risk |
Inaba et al. [21] | Moderate risk | Low risk | Low risk | Low risk | Unclear risk (no information) | Low to moderate risk | Moderate risk | Moderate risk |
Flint et al. [22] | Moderate risk | Low risk | Low risk | Low risk | Low risk | Low risk | Moderate risk | Moderate risk |
Outcome: nosocomial infections | ||||||||
Juffermans et al. [24] | Moderate risk | Low risk | Low risk | Low risk | Unclear risk (no information) | Low risk | Moderate risk | Moderate risk |
Juffermans et al. [25] | Moderate risk | Low risk | Low risk | Low risk | Unclear risk (no information) | Low risk | Moderate risk | Moderate risk |
Outcome: bleeding | ||||||||
Triulzi et al. [34] | Moderate risk | Low risk | Low risk | Low risk | Low risk | Low risk | Moderate risk | Moderate risk |
Outcome: CCI | ||||||||
Kerkhoffs et al. [32] | Moderate risk | Low risk | Low risk | Low risk | Low risk | Low risk | Moderate risk | Moderate risk |
Dijkstra-Tiekstra et al. [28] | Serious risk | Low risk | Low risk | Low risk | Moderate risk | Low risk | Moderate risk | Serious risk |
Van Rhenen et al. [35] | Moderate risk | Low risk | Low risk | Low risk | Low risk | Low risk | Moderate risk | Moderate risk |
Heuft et al. [33] | Serious risk | Low risk | Low risk | Low risk | Low risk | Moderate risk | Moderate risk | Serious risk |
Slichter et al. [12] | Moderate risk | Low risk | Low risk | Low risk | Low risk | Low risk | Moderate risk | Moderate risk |
Akkok et al. [31] | Moderate risk | Low risk | Low risk | Low risk | Low risk | Low risk | Moderate risk | Moderate risk |
Heim et al. [36] | Moderate risk | Low risk | Low risk | Low risk | Unclear risk (no information) | Low risk | Moderate risk | Moderate risk |
Dijkstra-Tiekstra et al. [29] | Moderate risk | Low risk | Low risk | Low risk | Low risk | Low risk | Moderate risk | Moderate risk |
Outcome: PLT CI | ||||||||
Kaplan et al., [30] | Serious | Low risk | Low risk | Low risk | Unclear risk | Low risk | Moderate risk | Serious risk |
Outcome: TRAE | ||||||||
Kaufman et al. [4] | Moderate risk | Low risk | Low risk | Low risk | Low risk | Low to moderate risk | Moderate risk | Moderate risk |