Effect of introduction of single-donor apheresis platelets in dengue management: A comparative analysis of two consecutive dengue epidemics

Sonam Kansay; Harinder Singh

doi:10.4103/JLP.JLP_10_17

Journal of Laboratory Physicians, Table of Contents

CC BY-NC-ND 4.0 · J Lab Physicians 2018; 10(02): 173-178
DOI: 10.4103/JLP.JLP_10_17

Original Article

Effect of introduction of single-donor apheresis platelets in dengue management: A comparative analysis of two consecutive dengue epidemics

Sonam Kansay

Department of Transfusion Medicine, Gian Sagar Medical College and Hospital, Patiala, Punjab, India

,

Harinder Singh

Department of Community Medicine, Gian Sagar Medical College and Hospital, Patiala, Punjab, India

› Author Affiliations

Abstract

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ABSTRACT

BACKGROUND: The frequency of dengue outbreak is increasing in Southeast Asian countries these days and since there are no specific drugs against the dengue virus; therefore, treatment consists of mainly symptomatic and supportive care.

AIMS: Platelet transfusion forms one of the major parts of treatment therapy in dengue; therefore, this study was initiated to elicit the effect of introduction of single-donor apheresis platelets (SDAPs) in dengue management.

SETTINGS AND DESIGN: This is a retrospective study conducted on 622 clinically suspected cases of dengue infection who received platelet transfusions between August 2013 and December 2015 in a teaching hospital of North India.

MATERIALS AND METHODS: Clinical data, reports of hematological investigation, transfusion request forms, platelet requirements, and data obtained from daily follow-up and blood bank records were analyzed using IBM SPSS version 20.

RESULTS: Average platelet count at which platelet transfusion initiated was 25,703/cumm. Average number of random donor platelets (RDPs) transfused significantly decreased in 2015 (2013 vs. 2015 is 5.4 vs. 4.3) due to the transfusion of SDAP to patients with very low platelet count and those with superimposed high-risk factors. Mean length of stay in hospital was similar for patients receiving RDP only and for those receiving RDP and SDAP both (5.48 vs. 5.54) while that for patients receiving SDAP only was quite lower (3.6). Overall cost of stay was higher for those receiving SDAP transfusions.

CONCLUSION: Decision for initiating platelet transfusions and calculating its dose for dengue patients is highly variable, but transfusing high-dose platelets such as SDAP at an appropriate stage can reduce further requirement of platelet transfusions, fasten the recovery, reduce the hospital stay, lower the risk of transfusion-associated adverse reactions, and can further minimize the associated morbidity and mortality.

Keywords

Dengue fever/dengue hemorrhagic fever/dengue shock syndrome - random donor platelets - single-donor apheresis platelets

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References

References
1 Gubler DJ, Clark GG. Dengue/dengue hemorrhagic fever: The emergence of a global health problem. Emerg Infect Dis 1995;1:55-7.
2 Teo D, Ng LC, Lam S. Is dengue a threat to the blood supply? Transfus Med 2009;19:66-77.
3 Tai DY, Chee YC, Chan KW. The natural history of dengue illness based on a study of hospitalised patients in Singapore. Singapore Med J 1999;40:238-42.
4 Chairulfatah A, Setiabudi D, Agoes R, Colebunder R. Thrombocytopenia and platelet transfusions in dengue hemorrhagic fever and dengue shock syndrome. WHO Dengue Bull 2003;27:141-3.
5 Chuansumrit A, Tangnararatchakit K. Pathophysiology and management of dengue hemorrhagic fever. Transfus Altern Transfus Med 2006;8:3-11.
6 World Health Organization. Guidelines for Treatment of Dengue Fever/Dengue Haemorrhagic Fever in Small Hospitals. Recognition of Dengue Fever/Dengue Haemorrhagic Fever (DF/DHF). Grading the Severity of Dengue Infection. New Delhi: World Health Organization; 1999. p. 2-3.
7 Ahmed NH, Broor S. Dengue fever outbreak in Delhi, North India: A clinico-epidemiological study. Indian J Community Med 2015;40:135-8.
8 McBride WJ, Bielefeldt-Ohmann H. Dengue viral infections; pathogenesis and epidemiology. Microbes Infect 2000;2:1041-50.
9 Katyal R, Singh K, Kumar K. Seasonal variations in A. aegypti population in Delhi, India. Dengue Bull 1996;20:78-81.
10 Ippolito G, Feldmann H, Lanini S, Vairo F, Di Caro A, Capobianchi MR, et al. Viral hemorrhagic fevers: Advancing the level of treatment. BMC Med 2012;10:31.
11 Chaurasia R, Zaman S, Chatterjee K, Das B. Retrospective review of platelet transfusion practices during 2013 dengue epidemic of Delhi, India. Transfus Med Hemother 2015;42:227-31.
12 Makroo RN, Raina V, Kumar P, Kanth RK. Role of platelet transfusion in the management of dengue patients in a tertiary care hospital. Asian J Transfus Sci 2007;1:4-7.
13 Gupta E, Dar L, Kapoor G, Broor S. The changing epidemiology of dengue in Delhi, India. Virol J 2006;3:92.
14 Khan E, Siddiqui J, Shakoor S, Mehraj V, Jamil B, Hasan R. Dengue outbreak in Karachi, Pakistan, 2006: Experience at a tertiary care center. Trans R Soc Trop Med Hyg 2007;101:1114-9.
15 Pang J, Salim A, Lee VJ, Hibberd ML, Chia KS, Leo YS, et al. Diabetes with hypertension as risk factors for adult dengue hemorrhagic fever in a predominantly dengue serotype 2 epidemic: A case control study. PLoS Negl Trop Dis 2012;6:e1641.
16 Figueiredo MA, Rodrigues LC, Barreto ML, Lima JW, Costa MC, Morato V, et al. Allergies and diabetes as risk factors for dengue hemorrhagic fever: Results of a case control study. PLoS Negl Trop Dis 2010;4:e699.
17 World Health Organization. Dengue and Dengue Haemorrhagic Fever. WHO Fact Sheet. Geneva: WHO; 2008.
18 Pallavi P, Ganesh CK, Jayashree K, Manjunath GV. Unfurling the rationale use of platelet transfusion in dengue Fever. Indian J Hematol Blood Transfus 2011;27:70-4.
19 Kaur P, Kaur G. Transfusion support in patients with dengue fever. Int J Appl Basic Med Res 2014;4 Suppl 1:S8-12.
20 Ahluwalia G, Sharma SK. Dengue: Current trends and challenges – An Indian perspective. J Assoc Physicians India 2004;52:561-3.
21 Khan Assir MZ, Kamran U, Ahmad HI, Bashir S, Mansoor H, Anees SB, et al. Effectiveness of platelet transfusion in dengue fever: A randomized controlled trial. Transfus Med Hemother 2013;40:362-8.
22 Jayashree K, Manasa GC, Pallavi P, Manjunath GV. Evaluation of platelets as predictive parameters in dengue fever. Indian J Hematol Blood Transfus 2011;27:127-30.
23 Murali Mohan KK, Rao BB, Raghuram C, Gunnam S, Dharmateja D, Gopidi A. A clinical study of dengue fever cases: NRI Medical College, Chinakakani, Andhra Pradesh, South India. Int J Med Public Health 2015;5:367-71.
24 Chatterjee K, Coshic P, Borgohain M, Agarwal N. Experience of buffy coat pooling of platelets as a supportive care in thrombocytopenic dengue patients: A prospective study. Asian J Transfus Sci 2014;8:89-91.
25 Singh RP, Marwaha N, Malhotra P, Dash S. Quality assessment of platelet concentrates prepared by platelet rich plasma-platelet concentrate, buffy coat poor-platelet concentrate (BC-PC) and apheresis-PC methods. Asian J Transfus Sci 2009;3:86-94.