Predictors of Corrected Count Increment after Pooled Platelet Concentrate Transfusion in Thrombocytopenic Patients: A Cohort Study

Introduction: Platelet transfusion is essential in managing thrombocytopenic patients to prevent or control bleeding. Corrected Count Increment (CCI) is a key measure of transfusion efficacy. Although apheresis Platelet Concentrates (PCs) from Single Donor Platelet (SDP) offers the highest platelet yield, they require more time, higher costs, specialised equipment, trained personnel and extensive donor counselling. In contrast, pooled PCs prepared by the Platelet-Rich Plasma (PRP) method serve as a practical and feasible alternative for blood centres with component separation facilities. The present study explores predictors influencing CCI following pooled PCs transfusion prepared by the PRP method. Aim: To assess the CCI after pooled RDP transfusion. Materials and Methods: A prospective observational cohort study was conducted in the Department of Immunohaematology and Blood Transfusion, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, Odisha, India, for a period of two years (January 2023 to January 2025). A total of 205 thrombocytopenic patients were included in the study who received pooled Random Donor Platelet (RDP) prepared by the PRP method. Patient demographics, diagnosis, transfusion history and platelet component characteristics were recorded. Pre-transfusion Total Platelet Counts (TPC) of the patients and the TPC of pooled RDP bags was analysed using calibrated Sysmex seven part analyser (XN3100 model) in the Department of IHBT, KIMS. Pre and post-transfusion platelet counts were measured to calculate CCI at one hour and 24 hours. Results: Out of total 205 thrombocytopenic patients only 69 (33.65%) patients developed refractoriness. Logistic regression analysis revealed significant influence of active bleeding (p<0.001), drugs (p=0.011), days of storage of platelets (p<0.001) and ABO non identical platelet transfusions (p=0.001) on refractoriness. Conclusion: Identifying the predictors can optimise transfusion strategies and improve patient outcomes. A modest yet potentially clinically significant benefit was noted with the transfusion of pooled platelets concentrate by PRP method in thrombocytopenic patients.