Taxocenoses de serpentes em grupos fitofisionômicos de cerrado no Parque Nacional de Sete Cidades, Piracuruca, Piauí, Brasil

Este trabalho teve como objetivo principal inventariar a fauna de serpentes do Parque Nacional de Sete Cidades, Piraracuruca, Piauí, Brasil, enfocando os seguintes aspectos: composição, riqueza e abundância de espécies nos seus diversos habitats, padrões de atividade diária, dieta, reprodução e comparação de composição com outras áreas estudadas por outros autores. Foram realizadas seis expedições ao Parque, entre setembro de 2005 e agosto de 2006, que totalizaram 120 dias de trabalho de campo. Para a amostragem de campo, foram utilizados três métodos: procura limitada por tempo, armadilhas de interceptação e queda e encontros ocasionais. Foram registradas 87 serpentes, distribuídas em quatro famílias (Boidae, Colubridae, Elapidae, Viperidae), 18 gêneros e 24 espécies. A espécie dominante foi Thamnodynastes sp. A (13,1%), seguida de Oxyrhopus trigeminus e Micrurus ibiboboca (10, 3%). Houve um predomínio de espécies terrestres e com períodos de atividade diurna. Como em outras taxocenoses de áreas abertas os colubrídeos mostraram-se dominantes. A fitofisionomia Cerrado Típico apresentou maior diversidade de espécies, sendo as menores diversidades registradas no Campo Limpo e Cerrado Rupestre. O método que apresentou melhor desempenho foi procura limitada por tempo, contudo, a utilização dos métodos de coleta isolados não se mostrou eficiente para inventariar a fauna de serpentes, sendo necessário o uso conjunto destes métodos para uma melhor amostragem da área. Através da análise de ACOP e da análise de agrupamento, foi possível observar que apesar de haver uma semelhança florística e fisionomicamente com Cerrado, a composição de espécies mostrou maior similaridade faunística com taxocenoses de áreas transição Cerrado/Caatinga e Caatinga.

História natural e ecologia das serpentes da Floresta Nacional de Caxiuanã e áreas adjacentes, Pará, Brasil

A busca por padrões de estrutura e composição das comunidades é essencial para prover informações que permitam o manejo sustentado de populações e monitoramento de atividades antrópicas. Na região neotropical, onde ocorre grande riqueza de espécies e complexas relações ecológicas entre elas, estudos envolvendo ofidiofauna ainda são escassos, o que faz com que o entendimento dos processos responsáveis pela estruturação de suas comunidades ainda seja incipiente. No Brasil, vários trabalhos foram desenvolvidos na tentativa de explicitar os fenômenos responsáveis pelos padrões de ocorrência e interações das espécies de serpentes. Objetivando esclarecer quais os fatores que determinam os padrões observados e que afinidades (ecológicas e/ou históricas) as espécies compartilham, foi realizado estudo da taxocenose de serpentes da FLONA de Caxiuanã e áreas adjacentes, durante os anos de 2005 e 2006. Utilizou-se conjuntamente quatro métodos de amostragem (Procura Limitada por Tempo-PLT, Encontros Ocasionais-EO, Armadilhas de Interceptação e Queda-AIQ e Coletas por Terceiros-CT), em cinco áreas (IBAMA e Caquajó, no interior da FLONA de Caxiuanã; Enseada e dois pontos com influência antrópica: Marinaú e Mojuá, estando esses três últimos localizados em áreas adjacentes à FLONA. Foram registrados 378 espécimes distribuídos em cinco famílias, 35 gêneros e 50 espécies. Com os novos registros obtidos nesse estudo, o número de espécies de serpentes para a FLONA de Caxiuanã e áreas adjacentes passa de 63 para 69. Os métodos que apresentaram melhor desempenho em número de indivíduos foram PLT (199/378) e CT (159/378). EO (11/378) e AIQ (9/378) foram os métodos menos eficazes. A riqueza estimada (Jackknife 1), a partir de dados obtidos através de PLT, foi de 56 (+ ou – 4) espécies. O número de espécies estimado para as áreas preservadas foi maior que para áreas antropizadas. A composição das espécies de serpentes da área estudada apresentou maior similaridade com outras taxocenoses de áreas amazônicas. As espécies mais abundantes, acessadas através de PLT, foram Imantodes cenchoa, Corallus hortulanus e Leptodeira annulata. Quando todos os métodos foram considerados, Bothrops atrox, Imantodes cenchoa e Corallus hortulanus foram as espécies mais representadas. As áreas mais antropizadas, localizadas fora da FLONA (Marinaú e Mojuá), apresentaram menores abundância e riqueza de espécies em comparação com áreas protegidas, localizadas no interior da FLONA. Nove espécies foram consideradas potencialmente especialistas: Lachesis muta (pequenos mamíferos), Atractus schach (minhocas), Dipsas catesbyi (moluscos - lesmas), Helicops trivitatus e Hydrops triangularis (peixes), Siphlophis compressus (lagartos), Xenopholis scalaris, Taeniophallus brevirostris (anfíbios anuros) e Tantilla melanocephala (centopéias). Os itens mais acessados foram “lagartos”, “anfíbios anuros” e “pequenos mamíferos”. Serpentes com hábitos primária ou exclusivamente diurnas prevaleceram na comunidade analisada. A ausência de sazonalidade reprodutiva foi característica da maioria das espécies e isso se deve, muito provavelmente, à pouca diferença na temperatura ao longo do ano. A taxocenose de serpentes da FLONA de Caxiuanã e áreas adjacentes está, basicamente, formada por grupos contendo espécies onde, em geral, hábitos diários e de dieta estão sobrepostos. Além dos diversos fatores ecológicos, também fatores históricos, como adaptações morfológicas das espécies, têm grande influência na composição da taxocenose analisada. A grande dificuldade na realização de estudos de comunidades de serpentes está na escassez de dados das espécies, portanto torna-se imperioso que estudos de Ecologia e História Natural continuem sendo exaustivamente conduzidos em uma mesma localidade, objetivando a elucidação dos padrões de respostas aos diversos fatores relacionados à existência das espécies nos diferentes biomas.

Grain size effect on the structural and dielectric properties of Pb0.85La0.15TiO3 ferroelectric ceramic compound

This paper presents a study of the influence of particle size on the structural and dielectric properties of Pb0.85La0.15TiO3 (PLT15) ferroelectric ceramic samples. The samples were prepared with average grain size of 1.69 +/- 0.08 mu m and 146 +/- 8 nm using, respectively, conventional and spark plasma sintering techniques. A decrease in the tetragonality degree as the crystallite size decreased was explained by an internal stress caused by the existence of a large amount of grain boundaries. The local structure exhibited no significant modification and the dielectric measurements showed a diffuse phase transition and a reduction in the permittivity magnitude at T-m as the average grain size decreased. The nanostructured ceramic sample prepared at a relatively lower temperature and sintering time presented a dielectric constant value of approximately 2000 at room temperature. (c) 2012 Elsevier Ltd and Techna Group S.r.l. All rights reserved.

Blood transfusion utilization and recipient survival at Hospital das Clinicas in Sao Paulo, Brazil

BACKGROUND: The characteristics of blood recipients including diagnoses associated with transfusion and posttransfusion survival are unreported in Brazil. The goals of this analysis were: 1) to describe blood utilization according to clinical diagnoses and patient characteristics and 2) to determine the factors associated with survival of blood recipients. STUDY DESIGN AND METHODS: A retrospective cross-sectional analysis was conducted on all inpatients in 2004. Data came from three sources: The first two files consist of data about patient characteristics, clinical diagnosis, and transfusion. Analyses comparing transfused and nontransfused patients were conducted. The third file was used to determine survival recipients up to 3 years after transfusion. Logistic regression was conducted among transfused patients to examine characteristics associated with survival. RESULTS: In 2004, a total of 30,779 patients were admitted, with 3835 (12.4%) transfused. These patients had 10,479 transfusions episodes, consisting of 39,561 transfused components: 16,748 (42%) red blood cells, 15,828 (40%) platelets (PLTs), and 6190 (16%) plasma. The median number of components transfused was three (range, 1-656) per patient admission. Mortality during hospitalization was different for patients whose admissions included transfusion or not (24% vs. 4%). After 1 year, 56% of transfusion recipients were alive. The multivariable model of factors associated with mortality after transfusion showed that the most significant factors in descending order were hospital ward, increasing age, increasing number of components transfused, and type of components received. CONCLUSION: Ward and transfusion are markers of underlying medical conditions and are associated with the probability of survival. PLT transfusions are common and likely reflect the types of patients treated. This comprehensive blood utilization study, the first of its kind in Brazil, can help in developing transfusion policy analyses in South America.

CRRT nel paziente ad alto rischio emorragico: ottimizzazione di un protocollo di anticoagulazione regionale con citrato

L’anticoagulazione regionale con citrato (RCA) è una valida opzione in pazienti ad alto rischio emorragico. Lo scopo del nostro studio è stato di valutare, in pazienti critici sottoposti a CRRT per insufficienza renale acuta post-cardiochirurgica, efficacia e sicurezza di un protocollo di RCA in CVVH con l’impiego di una soluzione di citrato a bassa concentrazione (12mmol/L). Metodi: L’RCA-CVVH è stata adottata come alternativa all’eparina o alla CRRT senza anticoagulante (no-AC). Criteri per lo switch verso l’RCA: coagulazione dei circuiti entro 24h o complicanze legate all’eparina. Per facilitare l’impostazione dei parametri CVVH, abbiamo sviluppato un modello matematico per stimare il carico metabolico di citrato e la perdita di calcio. Risultati: In 36 mesi, sono stati sottoposti a RCA-CVVH 30 pazienti. La durata dei circuiti con RCA (50.5 ± 35.8 h, mediana 41, 146 circuiti) è risultata significativamente maggiore (p<0.0001) rispetto all’eparina (29.2±22.7 h, mediana 22, 69 circuiti) o alla no-AC CRRT (24.7±20.6 h, mediana 20, 74 circuiti). Il numero di circuiti funzionanti a 24, 48, 72 h è risultato maggiore durante RCA (p<0.0001). I target di Ca++ sistemico e del circuito sono stati facilmente mantenuti (1.18±0.13 e 0.37±0.09 mmol/L). Durante l’RCA-CVVH nessun paziente ha avuto complicanze emorragiche e il fabbisogno trasfusionale si è ridotto rispetto alle altre modalità (0.29 vs 0.69 unità/die, p<0.05). Le piastrine (p=0.012) e l’AT-III (p=0.004) sono aumentate durante RCA riducendo la necessità di supplementazione. L’RCA è stata interrotta per accumulo di citrato in un solo paziente (calcemia totale/s-Ca++ >2.5). Conclusioni: L’RCA ha consentito di prolungare la durata dei circuiti riducendo il fabbisogno trasfusionale e la necessità di supplementazione di AT-III e piastrine. L’utilizzo di un modello matematico ha facilitato l’impostazione dei parametri CVVH. L’RCA appare meritevole di maggiore considerazione come metodica di anticoagulazione di prima scelta in pazienti ad alto rischio emorragico sottoposti a CRRT.

Blood component ratios in massively transfused, blunt trauma patients--a time-dependent covariate analysis

This study evaluated critical thresholds for fresh frozen plasma (FFP) and platelet (PLT) to packed red blood cell (PRBC) ratios and determined the impact of high FFP:PRBC and PLT:PRBC ratios on outcomes in patients requiring massive transfusion (MT).

Platelet Recruitment during Multiple Donor Platelet Apheresis Differs between Cell Separators

SUMMARY: BACKGROUND: Recruitment of platelets (PLT) during donor PLT apheresis may facilitate the harvest of multiple units within a single donation. METHODS: We compared two PLT apheresis procedures (Amicus and Trima Accel) in a prospective, randomized, paired cross-over study in 60 donors. The 120 donations were compared for depletion of circulating PLT in the donors, PLT yields and PLT recruitment. A recruitment was defined as ratio of total PLT yield and donor PLT depletion > 1. RESULTS: Despite comparable differences of pre- and post-apheresis PLT counts (87 × 10(9)/l in Trima Accel vs. 92 × 10(9)/l in Amicus, p = 0.383), PLT yields were higher with Trima Accel (7.48 × 10(11) vs. 6.06 × 10(11), p < 0.001), corresponding to a higher PLT recruitment (1.90 vs. 1.42, p < 0.001). We observed a different increase of WBC counts after aphereses, which was more pronounced with Trima Accel than with Amicus (1.30 × 10(9)/l vs. 0.46 × 10(9)/l, p < 0.001). CONCLUSION: Both procedures induced PLT recruitment. This was higher in Trima Accel, contributing to a higher yield in spite of a comparable depletion of circulating PLT in the donors. This recruitment facilitates the harvest of multiple units within a single donation and seems to be influenced by the procedure utilized. The different increases of circulating donor white blood cells after donation need further investigation.

Prospective, paired crossover comparison of multiple, single-needle plateletpheresis procedures with the Amicus and Trima Accel cell separators

BACKGROUND: The Baxter Amicus Version 2.51 (A) and the Gambro BCT Trima Accel Version 5.0 (T) cell separators may produce multiple platelet (PLT) concentrates within a single donation. STUDY DESIGN AND METHODS: The single-needle multiple plateletpheresis procedures of the two devices were compared in a prospective, randomized, paired crossover study in 60 donors. The 120 donations were compared for donor comfort, collection efficiency, residual white blood cell (WBC) count, and (in selected patients) corrected count increment (CCI). RESULTS: The mean PLT yield and the resultant mean number of units per donation were significantly lower for A (6.06 x 10(11) vs. 7.48 x 10(11) and 2.57 vs. 3.19, respectively, both p < 0.001), in spite of a longer apheresis duration (89 min vs. 79 min; p < 0.001). This resulted in a higher collection rate of T (5.68 x 10(11) PLTs/hr vs. 4.10 x 10(11) PLTs/hr, p < 0.001). Residual WBC count of every unit was fewer than 5 x 10(6), but significantly fewer A-PLT donations contained more than 10(5) WBCs per unit (1 vs. 9, p = 0.008). Although the ACD-A consumption was slightly higher for A (489 mL vs. 469 mL, p = 0.04), a trend to a higher frequency of side effects was found for T (42.4% vs. 23.7%, p = 0.06). The 1-hour CCIs of 33 transfused A-PLT units were comparable with those of 43 T-PLT units (11.8 vs. 13.9, p = 0.480). CONCLUSIONS: Both cell separators showed safe collections of up to 4 PLT units per donation with adequate CCI. T produced a higher PLT yield despite shorter apheresis duration, but with slightly higher residual WBC counts and a trend to a higher side-effect frequency.

Profiling of alterations in platelet proteins during storage of platelet concentrates

BACKGROUND: The quality of platelet concentrates (PCs) is primarily determined in vitro by selective methods (e.g., pH, aggregometry), which provide only limited information on certain platelet (PLT) characteristics. In contrast, proteomic technologies provide a comprehensive overview of the PLT proteome. High interassay variability, however, limits meaningful assessment of samples taken from the same product over time or before and after processing. STUDY DESIGN AND METHODS: Differential in-gel electrophoresis (DIGE) and mass spectrometry were applied to analyze changes in the PLT proteome during storage of PCs. RESULTS: DIGE provides a comprehensive and reproducible overview of the cytoplasmic PLT proteome (median standard deviation of protein spot intensities, 5%-9%). Although 97 percent of cytosolic PLT proteins remained unchanged over a 9-day storage period, septin 2 showed characteristic alterations that preceded by several days more widespread alterations affecting numerous other proteins. Also beta-actin and gelsolin are potential marker proteins for changes in the PLT proteome. Interestingly septin 2 and gelsolin are affected during apoptosis, indicating that apoptosis in PCs may have an impact on PLT storage. CONCLUSION: DIGE is a tool for comprehensively assessing the impact of storage on the global proteome profile of therapeutic PCs. Most of the changes detected are in high-abundance PLT proteins.

Effects of high-yield thrombocytapheresis on the quality of platelet products

BACKGROUND: The steadily increasing demands for single-donor apheresis platelet (PLT) concentrates (APCs) are a challenge to the PLT supply system. Therefore, efforts to improve plateletpheresis yield, allowing apheresis products to be split into 2 or more units, are valuable strategies. No data to demonstrate in vivo transfusion efficacy of these high-yield split-APCs are currently available, however. STUDY DESIGN AND METHODS: The transfusion efficacy of APCs produced by two apheresis methods involving different harvest and storing procedures and varying PLT yields was investigated. Efficacy measures were the 1-hour percent PLT recovery (PPR(1h)) and the 1-hour corrected count increment (CCI(1h)). In total, 400 APCs, produced with either an Amicus device (Baxter) and stored in PLT additive solution (T-Sol; Amicus method [AM], n = 107) or a Trima device (Gambro) and stored in plasma (Trima method [TM], n = 293), were transfused to 55 children (31 girls; median age, 9.5 years; range, 0.2-18.5 years) with thrombocytopenia due to chemotherapy or aplastic anemia (median, 4 APCs per child; range, 1-68). RESULTS: Transfusion efficacy was significantly lower for AM-APCs than for TM-APCs (median PPR(1h), 17 and 33%; median CCI(1h), 7.9 and 15.6, respectively; p < 0.001). Reduced transfusion efficacy correlated in a yield-dependent manner with high apheresis PLT yields (>/=6 x 10(11)) for AM-APCs (p < 0.001). CONCLUSION: Although in vitro validation of AM- and TM-APCs has been performed, only by evaluating transfusion efficacy in vivo did the AM turn out to be not suitable for high-yield thrombocytapheresis. This study recommends the implementation of in vivo transfusion efficacy studies for high-yield APC apheresis donations.

Transfusion efficacy of ABO major-mismatched platelets (PLTs) in children is inferior to that of ABO-identical PLTs

BACKGROUND: ABO major compatibility is essential in transfusions of red blood cells but is not requisite in PLT transfusions. In adults there is some evidence that transfusion efficacy of ABO blood group-identical platelets (PLTs) is superior to major-mismatched PLTs. However, in children this question has not been investigated for more than 30 years. STUDY DESIGN AND METHODS: In a prospective study, the efficacy (based on the 1-hour percentage of PLT recovery [PPR(1hr)]) of 400 eligible ABO blood group-identical or out-of-group apheresis PLT concentrates (APCs), transfused mainly prophylactically to 50 children with hematologic malignancies, solid tumors, or aplastic anemia was investigated. The primary objective was to compare PPR(1hr) between ABO-identical and major-mismatched transfusions. RESULTS: After ABO major-mismatched transfusions, PPR(1hr) was significantly lower than after ABO blood group-identical transfusions (median 21% vs. 32%; p = 0.034). Multivariate analysis showed major-mismatched transfusions to be significantly more often unsuccessful than identical transfusions (odds ratio [OR], 3.97; 95% confidence interval [CI], 1.52-10.39; p = 0.005). Using flow cytometry and fluorescent microscopy, it could be demonstrated that PLTs of subgroup A(1), significantly expressing A antigen on their surface, were rapidly cleared from the circulation of group O or B recipients. In contrast, major-mismatched transfusions of A(2) PLTs, expressing no detectable A antigen, were as successful as identical transfusions (OR, 1.13; 95% CI, 0.16-7.88; p = 0.90). CONCLUSION: These data clearly indicate that in children ABO major-mismatched PLT transfusions result in inferior transfusion efficacy, with the only exception of group A(2) PLTs. ABO minor-mismatched PLTs showed comparable efficacy to identical transfusions.

Clinical outcomes after platelet transfusions in patients with thrombotic thrombocytopenic purpura

BACKGROUND: Reports of deterioration and death after platelet (PLT) transfusions in patients with thrombotic thrombocytopenic purpura (TTP) have led to recommendations that they should not be given except for life-threatening hemorrhage. STUDY DESIGN AND METHODS: Published reports of PLT transfusions in patients with TTP were systematically reviewed and data from the Oklahoma TTP-HUS Registry, an inception cohort of 382 consecutive patients, 1989 through 2007, were analyzed. RESULTS: A systematic review identified 34 publications describing outcomes of patients with TTP after PLT transfusions: 9 articles attributed complications to PLT transfusions, 4 suggested that they may be safe, and 21 articles did not comment about a relation between PLT transfusions and outcomes. Fifty-four consecutive patients from the Oklahoma TTP-HUS Registry were prospectively analyzed. ADAMTS13 activity was less than 10 percent in 47 patients; also included were 7 patients whose activity was not measured but who may have been deficient. Thirty-three (61%) patients received PLT transfusions. The frequency of death was not different between the two groups (p = 0.971): 8 (24%) patients who received PLT transfusions died (thrombosis, 5; hemorrhage, 1; sepsis, 2) and 5 (24%) patients who did not receive PLT transfusions died (thrombosis, 4; hemorrhage, 1). The frequency of severe neurologic events was also not different (p = 0.190): 17 (52%) patients who received PLT transfusions (in 5 of these 17 patients, neurologic events only occurred before PLT transfusions) and 7 (33%) patients who did not receive PLT transfusions. CONCLUSION: Evidence for harm from PLT transfusions in patients with TTP is uncertain.

Impact of changes in haematocrit level and platelet count on thromboelastometry parameters

INTRODUCTION To what extent haematocrit levels (Hct) and platelet counts (PLT) influence the measurement of parameters of thromboelastometry when assessed with the ROTEM® device is unclear. We investigated to what extent thromboelastometry measurements depend on Hct and PLT. MATERIALS AND METHODS Whole blood samples were taken for in-vitro preparations of mixtures with three different levels of PLT and a varying Hct. Maximum clot firmness (MCF), clotting time (CT), clot formation time (CFT) and alpha angle (α) for INTEM, EXTEM, FIBTEM and APTEM was recorded. RESULTS Measurements depended substantially on Hct and PLT. MCF readings were systematically lower with increasing Hct (0.2 vs. 0.4: -7.8 (-8.3 to -7.2); p<0.001, 0.2 vs. 0.55: -14.5 (-17.3 to -14.3); p<0.001) but higher with increasing PLT (50 vs. 125×10(9)/l: 8.2 (4.2 to 12.3); p=0.005, 50 vs. 250×10(9)/l: 12.0 (7.2 to 16.8); p=0.002). CT readings were systematically higher with increasing Hct (0.2 vs. 0.4: 9.2 (6.2 to 12.1); p=0.001, 0.2 vs. 0.55: 38.2 (21.5 to 54.9); p=0.003) while increasing PLT had no influence. CFT readings were also systematically higher with increasing Hct (0.2 vs. 0.4: 83.8 (40.2 to 127.6); p=0.006, 0.2 vs. 0.55: 226.2 (110.7 to 341.7); p=0.006) but systematically lower with increasing PLT (50 vs. 125×10(9)/l: -144.0 (-272.3 to -15.6); p=0.036, 50 vs. 250×10(9)/l: -189.2 (-330.4 to -48.0); p=0.02); readings of the alpha angle showed a similar pattern. CONCLUSIONS Our results suggest that readings of thromboelastometry parameters need to be adjusted by Hct and PLT to avoid potential confounding and miss-interpretations in clinical practice.

A case of EDTA-dependent pseudothrombocytopenia: simple recognition of an underdiagnosed and misleading phenomenon

1. BMC Clin Pathol. 2014 May 1;14:19. doi: 10.1186/1472-6890-14-19. eCollection 2014. A case of EDTA-dependent pseudothrombocytopenia: simple recognition of an underdiagnosed and misleading phenomenon. Nagler M, Keller P, Siegrist D, Alberio L. Author information: Department of Hematology and Central Hematology Laboratory, Inselspital University Hospital and University of Berne, CH-3010 Berne, Switzerland. BACKGROUND: EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) is a common laboratory phenomenon with a prevalence ranging from 0.1-2% in hospitalized patients to 15-17% in outpatients evaluated for isolated thrombocytopenia. Despite its harmlessness, EDTA-PTCP frequently leads to time-consuming, costly and even invasive diagnostic investigations. EDTA-PTCP is often overlooked because blood smears are not evaluated visually in routine practice and histograms as well as warning flags of hematology analyzers are not interpreted correctly. Nonetheless, EDTA-PTCP may be diagnosed easily even by general practitioners without any experiences in blood film examinations. This is the first report illustrating the typical patterns of a platelet (PLT) and white blood cell (WBC) histograms of hematology analyzers. CASE PRESENTATION: A 37-year-old female patient of Caucasian origin was referred with suspected acute leukemia and the crew of the emergency unit arranged extensive investigations for work-up. However, examination of EDTA blood sample revealed atypical lymphocytes and an isolated thrombocytopenia together with typical patterns of WBC and PLT histograms: a serrated curve of the platelet histogram and a peculiar peak on the left side of the WBC histogram. EDTA-PTCP was confirmed by a normal platelet count when examining citrated blood. CONCLUSION: Awareness of typical PLT and WBC patterns may alert to the presence of EDTA-PTCP in routine laboratory practice helping to avoid unnecessary investigations and over-treatment. PMCID: PMC4012027 PMID: 24808761 [PubMed]

Transfusion efficacy of apheresis platelet concentrates irradiated at the day of transfusion is significantly superior compared to platelets irradiated in advance.

BACKGROUND Gamma irradiation is currently the standard care to avoid transfusion-associated graft-versus-host disease. Guidelines on gamma irradiation of blood components state that platelets (PLTs) can be irradiated at any stage in their 5-day storage and can thereafter be stored up to their normal shelf life of 5 days after collection. In this study, we explored whether the timing of irradiation has an effect on transfusion efficacy of apheresis PLT concentrates (APCs). METHODS Based on the 1-hour percent PLT recovery (PPR1h), transfusion efficacy of 1,000 eligible APCs transfused to 144 children were evaluated retrospectively. PPR1h was compared in transfused APCs irradiated at the day of transfusion and APCs irradiated in advance. RESULTS In univariate analysis, transfusion efficacy of APCs irradiated in advance was significantly lower than that of APCs irradiated at the day of transfusion (mean PPR1h 27.7 vs. 35.0%; p = 0.007). This was confirmed in multivariate analysis (p = 0.030). Compared to non-irradiated APCs, transfusion efficacy of APCs irradiated at the day of transfusion was not significantly inferior (mean difference -2.8%; 95% CI -6.1 to 0.5%; p = 0.092), but APCs irradiated in advance were clearly less efficient (mean difference -8.1%; 95% CI -12.2 to -4.0%; p < 0.001). CONCLUSION Our data strongly support that APCs should not be irradiated in advance, 1.e., ≥24 h before transfusion.