Pathogen-reduced platelets raised neonatal counts, but 191 historical patients cannot settle safety

In a 191-neonate before-and-after cohort, mean platelet-count increments were 82.9 versus 95.9 ×10^9/L after pathogen-reduced and conventional components (P=0.069). The eras were 2005-2010 and 2011-2015, the cohort was too small to exclude rare harm, and bleeding progression, infection markers, and cause-specific mortality were not reported.

THE HOT TAKE

The platelet-count response is reassuring. The clinical-safety claim remains larger than the evidence.

A single-center retrospective study in Bern compared two nonconcurrent eras. Ninety-two term and preterm neonates received 180 conventional platelet components during 2005-2010, while 99 neonates received 225 amotosalen-ultraviolet A pathogen-reduced components during 2011-2015. Eligible infants were 28 days old or younger.

Pathogen reduction was bundled with other product changes. Conventional components were gamma irradiated, while pathogen-reduced components were not; collection method, additive solution, and permitted storage time also differed. The investigators did not record the exact platelet dose or storage age for each transfusion, so the study cannot isolate the effect of pathogen reduction itself.