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. 2023 Jan;118(1):16-23.
doi: 10.1111/vox.13387. Epub 2022 Dec 1.

Systematic reviews on platelet transfusions: Is there unnecessary duplication of effort? A scoping review

Bert Avau  1 , Dorien O  1 , Koen Veys  1 , Jørgen Georgsen  2 , Susan Nahirniak  3   4 , Nadine Shehata  5 , Simon J Stanworth  6   7   8 , Hans Van Remoortel  1   9 , Emmy De Buck  1   9 , Veerle Compernolle  10   11 , Philippe Vandekerckhove  9   12   13
Affiliations

Systematic reviews on platelet transfusions: Is there unnecessary duplication of effort? A scoping review

Bert Avau et al. Vox Sang. 2023 Jan.

Abstract

Background and objectives: Platelet transfusions are used across multiple patient populations to prevent and correct bleeding. This scoping review aimed to map the currently available systematic reviews (SRs) and evidence-based guidelines in the field of platelet transfusion.

Materials and methods: A systematic literature search was conducted in seven databases for SRs on effectiveness (including dose and timing, transfusion trigger and ratio to other blood products), production modalities and decision support related to platelet transfusion. The following data were charted: methodological features of the SR, population, concept and context features, outcomes reported, study design and number of studies included. Results were synthesized in interactive evidence maps.

Results: We identified 110 SRs. The majority focused on clinical effectiveness, including prophylactic or therapeutic transfusions compared to no platelet transfusion (34 SRs), prophylactic compared to therapeutic-only transfusion (8 SRs), dose, timing (11 SRs) and threshold for platelet transfusion (15 SRs) and the ratio of platelet transfusion to other blood products in massive transfusion (14 SRs). Furthermore, we included 34 SRs on decision support, of which 26 evaluated viscoelastic testing. Finally, we identified 22 SRs on platelet production modalities, including derivation (4 SRs), pathogen inactivation (6 SRs), leucodepletion (4 SRs) and ABO/human leucocyte antigen matching (5 SRs). The SRs were mapped according to concept and clinical context.

Conclusion: An interactive evidence map of SRs and evidence-based guidelines in the field of platelet transfusion has been developed and identified multiple reviews. This work serves as a tool for researchers looking for evidence gaps, thereby both supporting research and avoiding unnecessary duplication.

Keywords: decision support; haemostasis; platelet apheresis; platelet transfusion; scoping review; thrombocytopenia; viscoelastic.

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Conflict of interest statement

Relevant financial conflicts of interest directly related to this review: Bert Avau, Dorien O, Koen Veys, Hans Van Remoortel, Jørgen Georgsen, Nadine Shehata, Simon J. Stanworth, Emmy De Buck, Veerle Compernolle and Philippe Vandekerckhove declared not having any relevant direct financial conflict of interest. Susan Nahirniak declared to have received travel reimbursements from the Canadian Blood Services for travel to Scientific Research Advisory Committee, which occasionally discusses International Collaboration for Transfusion Medicine Guidelines (ICTMG) projects.

Relevant financial conflicts of interest not directly related to this review: Bert Avau, Dorien O, Koen Veys, Hans Van Remoortel, Emmy De Buck, Veerle Compernolle and Philippe Vandekerckhove are employees of Belgian Red Cross‐Flanders, which is responsible for supplying adequate quantities of safe blood products to hospitals in Flanders and Brussels on a continuous basis and is funded by the Ministry of Social Affairs. Belgian Red Cross‐Flanders received a grant from the European Blood Alliance to conduct this review. Nadine Shehata reported having received personal fees from the ICTMG for the development of the ICTMG platelet guideline. Simon J. Stanworth declared being an employee of the NHSBT, a blood service supplier for England, which manufactures platelets and having received grants for the conduct of trials of platelets in neonates and platelets and tranexamic acid in haematological cancers. Jørgen Georgsen and Susan Nahirniak declared not having any other relevant financial conflicts of interest.

Relevant intellectual conflicts of interest: Bert Avau, Dorien O, Koen Veys, Hans Van Remoortel, Jørgen Georgsen, Emmy De Buck, Veerle Compernolle and Philippe Vandekerckhove declared not having any intellectual conflict of interest. Simon J. Stanworth declared having authored multiple systematic reviews (SRs) on the use of platelets and tranexamic acid in haematology—none within the last three years and being involved in a new guideline on platelets and plasma in critically ill children. Simon J. Stanworth and Susan Nahirniak declared being the co‐chair of the platelet guideline revision working group of the ICTMG. Nadine Shehata declared having been a co‐author on previous SRs and a guideline on platelet transfusion.

Figures

FIGURE 1
FIGURE 1
Evidence map illustrating the number of identified systematic reviews, mapped by clinical context and concept, segmented by study design included
FIGURE 2
FIGURE 2
Evidence map illustrating the number of identified systematic reviews, mapped by clinical context and concept, segmented by age category
FIGURE 3
FIGURE 3
Evidence map illustrating the number of identified systematic reviews, mapped by clinical context and concept, segmented by outdatedness
See this image and copyright information in PMC

References

    1. Macfarlane RG. An enzyme cascade in the blood clotting mechanism, and its function as a biochemical amplifier. Nature. 1964;202:498–9. - PubMed
    1. Estcourt LJ, Malouf R, Hopewell S, Doree C, Van Veen J. Use of platelet transfusions prior to lumbar punctures or epidural anaesthesia for the prevention of complications in people with thrombocytopenia. Cochrane Database Syst Rev. 2018;4:CD011980. - PMC - PubMed
    1. Neunert C, Lim W, Crowther M, Cohen A, Solberg L Jr, Crowther MA, et al. The American Society of Hematology 2011 evidence‐based practice guideline for immune thrombocytopenia. Blood. 2011;117:4190–207. - PubMed
    1. Freireich EJ. Origins of platelet transfusion therapy. Transfus Med Rev. 2011;25:252–6. - PubMed
    1. Murphy S, Gardner FH. Effect of storage temperature on maintenance of platelet viability—deleterious effect of refrigerated storage. N Engl J Med. 1969;280:1094–8. - PubMed

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