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. 2023 Sep;108(5):452-457.
doi: 10.1136/archdischild-2022-324915. Epub 2023 Feb 21.

Two-year outcomes following a randomised platelet transfusion trial in preterm infants

Carmel Maria Moore  1   2 , Angela D'Amore  3 , Suzanne Fustolo-Gunnink  4 , Cara Hudson  5 , Alice Newton  5 , Beatriz Lopez Santamaria  6 , Alison Deary  5 , Renate Hodge  5 , Valerie Hopkins  5 , Ana Mora  5 , Charlotte Llewelyn  5 , Vidheya Venkatesh  7 , Rizwan Khan  8 , Karen Willoughby  3 , Wes Onland  9 , Karin Fijnvandraat  10 , Helen V New  11 , Paul Clarke  12   13 , Enrico Lopriore  14 , Timothy Watts  15 , Simon Stanworth  16 , Anna Curley  17   2 ; PlaNeT2 MATISSE
Collaborators, Affiliations

Two-year outcomes following a randomised platelet transfusion trial in preterm infants

Carmel Maria Moore et al. Arch Dis Child Fetal Neonatal Ed. 2023 Sep.

Abstract

Objective: Assess mortality and neurodevelopmental outcomes at 2 years of corrected age in children who participated in the PlaNeT-2/MATISSE (Platelets for Neonatal Transfusion - 2/Management of Thrombocytopenia in Special Subgroup) study, which reported that a higher platelet transfusion threshold was associated with significantly increased mortality or major bleeding compared to a lower one.

Design: Randomised clinical trial, enrolling from June 2011 to August 2017. Follow-up was complete by January 2020. Caregivers were not blinded; however, outcome assessors were blinded to treatment group.

Setting: 43 level II/III/IV neonatal intensive care units (NICUs) across UK, Netherlands and Ireland.

Patients: 660 infants born at less than 34 weeks' gestation with platelet counts less than 50×109/L.

Interventions: Infants were randomised to undergo a platelet transfusion at platelet count thresholds of 50×109/L (higher threshold group) or 25×109/L (lower threshold group).

Main outcomes measures: Our prespecified long-term follow-up outcome was a composite of death or neurodevelopmental impairment (developmental delay, cerebral palsy, seizure disorder, profound hearing or vision loss) at 2 years of corrected age.

Results: Follow-up data were available for 601 of 653 (92%) eligible participants. Of the 296 infants assigned to the higher threshold group, 147 (50%) died or survived with neurodevelopmental impairment, as compared with 120 (39%) of 305 infants assigned to the lower threshold group (OR 1.54, 95% CI 1.09 to 2.17, p=0.017).

Conclusions: Infants randomised to a higher platelet transfusion threshold of 50×109/L compared with 25×109/L had a higher rate of death or significant neurodevelopmental impairment at a corrected age of 2 years. This further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants.

Trial registration number: ISRCTN87736839.

Keywords: Child Development; Intensive Care Units, Neonatal; Neonatology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials flow diagram.
See this image and copyright information in PMC

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