Platelet-derived immune-modulatory mediators and transfusion: time to consider their effects?

Abstract

Preview
Platelet transfusions are crucial for curative or prophylactic supportive treatments to lower the risk of haemorrhage. Haemorrhage is associated with oncological diseases and their treatment, myelosuppression or during transplantation of haematopoietic stem cells, and with most invasive surgical procedures. In these cases, transfusion is then the only effective treatment.
Transfusion of platelets is generally safe and largely beneficial to patients. Inactivation of pathogens in platelet concentrates (PCs) lowers the risk of bacterial transfusion-transmitted infections, and platelet-related transfusion reactions in general. Platelets that have been treated with inactivation of pathogens are clearly distinct from platelets that have not been treated. Recent randomised controlled trials, however, found that transfusing pathogen-reduced platelets did not worsen outcome when compared to transfusing regular platelet components for preventing bleeding episodes. [ … ]