Does time of CCI measurement affect the evaluation of platelet transfusion effectiveness?

• Published in: Transfusion and apheresis science Vol. 60; no. 3; p. 103123
• Main Authors: Matsui, Reina, Hagino, Takeshi, Tsuno, Nelson Hirokazu, Ohtani, Hideo, Azuma, Fumihiro, Matsuhashi, Mika, Saito, Makoto, Kobayashi, Maya, Saga, Reina, Hidai, Hiroko, Tsutsumi, Hisashi, Akiyama, Hideki, Motomura, Sayuri
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2021
• Subjects: ABO-compatible platelet concentrate; Aged; Aged, 80 and over; Blood Preservation - methods; Female; Humans; Japanese guideline for the appropriate use of blood products (revised in 2017); Male; Platelet Transfusion - methods; Platelet transfusion refractoriness; Single donor apheresis platelets; The corrected count increment (CCI); Time Factors; The corrected count increment (CCI); Single donor apheresis platelets; Platelet transfusion refractoriness; Japanese guideline for the appropriate use of blood products (revised in 2017); ABO-compatible platelet concentrate
• ISSN: 1473-0502; 1878-1683
• DOI: 10.1016/j.transci.2021.103123

The measurement of corrected count increment at 1-h post-transfusion (CCI-1 h) of platelet concentrate (PC) transfusion is recommended, but in the revised Japanese Guideline (2017) it was changed to “after 10-min to 1-h”, following the revision of the guidelines from Western countries. Here, we aimed to investigate on the feasibility to apply the CCI measured at 10-min or 30-min post-transfusion as the surrogate of CCI-1 h. Peripheral blood was collected at 10-min, 30-min and 1-h post-transfusion of PC and the effectiveness of the transfusion was analyzed based on the CCI. In the period from December 2017 to February 2020, 8 patients, who received multiple PC transfusion (total 208) at our institution, were analyzed. We performed the univariate analyses to examine the relationship between CCI value and the categorical variables, p-value <0.1 was obtained for gender (p = 2.91 × 10−19), fever after transfusion (p = 0.0163). The qualitative variables, namely measurement time (p = 0.0553), also showed p-value <0.1. Using these factors as covariates in the mixed effect model, we found that the measurement time (p = 0.0007) had a significant effect on the CCI value when looking at fixed effects. Although there is a tendency for decreased CCI values with time progression, the slope of the change in the mixed model was -0.00307, indicating that the CCI difference among the 3 measurements was small. Here we provide evidence that CCI measured at 10-min and 30-min post-transfusion give results comparable to those measured at 1-h post-transfusion, under the Japanese practice of platelet transfusion, which relies on 100 % single-donor apheresis PC, and ABO-identical whenever possible.