(P-TS-36) Comparison of Post-Transfusion Platelet Counts Using Low Yield vs Standard Platelets

Background/Case Studies: Platelet (PLT) shortages have become a significant concern in the transfusion community. Collection thresholds have been lowered in many countries to 2.4 x 10¹¹ PLTs/unit to increase collections without relying on more donations. The PLADO study (2010) showed the U.S. standard dose of 3 x 10¹¹ PLTs/unit exceeds what is necessary for prophylactic use. As suppliers increasingly deliver low-yield (LY) units, we sought to demonstrate that the post-transfusion response from these units provided a clinically equivalent PLT count increase compared with standard (STD) units.

Study

Design/Methods: From July through December 2024, LY units were randomly administered per routine ordering. Patients who received a LY unit were retrospectively chart reviewed for demographics, pre- and post-transfusion PLT counts, and bleeding events. The same data were collected for STD units transfused to those patients before or after the LY units, enabling within-patient comparison of PLT count response. Individual product PLT counts and volumes were obtained from suppliers and the change in counts calculated. A one way ANOVA was used to compare post counts in those patients (n=7) who had a STD PLT unit (STD1), followed by a LY unit, followed by another STD unit (STD 2; Figure 1).

Results/Findings: Fourteen LY units were transfused to 12 patients in the 6-month period reviewed. All LY transfusions had at least 1 corresponding STD transfusion for comparison (29 STD units total). The average PLT dose was 2.85 x 10¹¹ PLT (2.66-2.95 x 10¹¹ PLT) and 3.65 x 10¹¹ PLT for the LY and STD units, respectively.



Of the units reviewed, 1 patient was excluded from the analysis (1 LY unit and 4 STD units) due to lack of a post-transfusion count associated with the LY unit and 1 STD unit was excluded due to lack of post-count information. Post-transfusion counts were taken between 15min and 12 hrs and 57 minutes post transfusion, with one LY unit’s post-counts not taken until 22 hrs and 58 minutes. That unit was included in analysis. Of the units reviewed, 77% of LY and 88% of STD units achieved post-transfusion PLT count increases > 5 x 10⁹/L when compared to the pre-transfusion count. No statistical difference was identified in the post-transfusion PLT count increase by unit type (Figure 1) and no bleeding events related to LY PLT administration were identified.

Conclusions: Consistent with prior studies, no significant difference was found in the post-transfusion counts of patients who received LY vs STD units. All LY units met or exceeded the 2.5 x 10¹¹ PLT/unit count recommended as an updated lower platelet threshold.¹



These findings support the proposed reduction in the current platelet collection yield recommended by FDA guidance. Based on our literature review and small in-house comparison, LY PLTs will continue to be accepted into our inventory and distributed as a part of standard inventory.