PB0132 - Hemostatic evaluation of patients with thrombocytopenia receiving platelet transfusion using the total thrombus formation analysis system (T-TAS)

Sunday, June 25, 2023

18:30 – 19:30 ET

Room: Exhibition

Co-Author(s)

Ana Monreal, MD

MD
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Murcia, Spain.
Murcia, Murcia, Spain

Co-Author(s)

RC

Rebeca Celdrán

MD
Servicio de Anestesia, Hospital Universitario Reina Sofia, Murcia, Spain
Murcia, Murcia, Spain
MA

María L Amigo

MD
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Murcia, Spain.
Murcia, Murcia, Spain
PG

Pedro L Gómez-González

Laboratory technician
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Murcia, Spain.
Murcia, Murcia, Spain
Ana Zamora-Cánovas

Biotechnology
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Murcia, Spain.
Murcia, Murcia, Spain
TC

Tzu Chen

MD, PhD
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Murcia, Spain.
Murcia, Murcia, Spain
CL

Carmen María López-López

MD
Servicio de Anestesia, Hospital Universitario Reina Sofia, Murcia, Spain
Murcia, Murcia, Spain
IZ

Isabel Zuazu-Jausoro

MD
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Murcia, Spain.
Murcia, Murcia, Spain
HC

Horacio Cano

MD
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Murcia, Spain.
Murcia, Murcia, Spain
MC

María José Candela

PhD
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Murcia, Spain.
Murcia, Murcia, Spain
Jp

Jorge pagán

MD
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Murcia, Spain.
Murcia, Murcia, Spain
JR

José Miguel Rivera-Caravaca

NT, PhD
Faculty of Nursing, University of Murcia, Murcia, Spain; Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Pascual Parrilla, CIBERCV, Murcia, Spain.
Murcia, Murcia, Spain
EP

Eva María Plaza-López

NT
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Murcia, Spain.
Murcia, Murcia, Spain
ML

María Luisa Lozano

Leader of Hematology Service in Murcia
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER, Murcia, Spain
Murcia, Murcia, Spain

Presenting Author(s)

José RIVERA Rivera, PhD

PhD
Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Murcia, Spain
Murcia, Murcia, Spain

Background: Criteria for therapeutic or prophylactic platelet transfusions in thrombocytopenic patients remain controversial. Global tests assessing the hemostatic status could be valuable for transfusion decision in these patients.

Aims: Assessing the hemostatic status of thrombocytopenic patients before and after platelet transfusion using the total thrombus formation analysis system (T-TAS).

Methods: Thirty-two thrombocytopenic patients (64.2±14.3y; platelets 28.5±21.0, 4.3-73.0 [x109/L]), received whole-blood derived platelet transfusions (3.2±0.75 x1011) as prophylaxis, for bleeding, or before an invasive procedure (14, 5 and 13 patients, respectively). The underlying pathology is specified in Table 1. According to the WHO bleeding scale (grades 0-4), 7(21.8%) and 25(78.2%) patients had mild (≤1)(mB) or severe (≥2)(MB) bleeding. Blood samples were drawn immediately before (BT) and 1h after transfusion (AT) for complete blood count, coagulation tests, fibrinogen (Fg], D-dimer, flow cytometry assessment of ADP(20uM) and PAR-1(25uM) induced platelet binding of Fg and P-Selectin (CD62) release, and HD chip test with T-TAS (Fujimori Kogyo Co). The study was approved by our Ethics Committee. Patients gave written informed consent.

Results: Table 2 summarizes the results. The mean corrected count increment (CCI) was 12.3±9.2, but 10(31%) cases showed CCI < 7.5. No changes were observed BT vs AT in hemoglobin levels, coagulation parameters or platelet fibrinogen binding or CD62 release. In HD-T-TAS, the overall area under curve (AUC) improved AT (528±533 vs. 722±553, p=0.03), but not in 7(22%) cases. Patients with MB vs. mB showed a higher CCI (17.0 vs. 10.7; p=0.037), a trend toward greater platelet fibrinogen binding and CD62 release (BT), and no difference in AUC. BT&AT, AUC values correlated (p>0.05) with hemoglobin, platelet count, prothrombin time, and platelet fibrinogen binding.

Conclusion(s): Platelet transfusion efficacy in thrombocytopenic patients shows large inter-patient variability according to CCI and platelet function. The HD T-TAS test correlates with hemostatic parameters.