Safe and Effective Neonatal Platelet Transfusions

A study funded by NHSBT is giving a better understanding of when to transfuse babies with low platelet counts.

Neonatologists have an incredible responsibility caring for the wellbeing of new born babies. When very premature babies are born with low platelet counts they need to know what is the safest and most effective way to transfuse platelets.

Previously clinical research had been quite limited in this field until the PlaNET-2: Platelets for Neonatal Transfusion study, a collaboration between NHSBT and Sanquin Blood Supply Foundation in the Netherlands, was carried out. The original trial began in the UK and the researchers were approached by collaborators in the Netherlands who had a shared interest in answering this important clinical question. The trial was sponsored by NHSBT and managed by the NHSBT Clinical Trials Unit.

Babies were divided at random (randomised) into one of two groups:

  • One group of babies received a platelet transfusion whenever their platelet count dropped below 50.
  • Another group received a platelet transfusion whenever their platelet count dropped below 25.

Dr Simon Stanworth, joint Chief Investigator, said: “Platelet transfusions have some risks, as for any blood component, but may also have benefits to reduce rates of bleeding. Our organisation is committed to generating robust evidence to influence clinical practice.

“660 babies took part, making it one of the largest studies to date of transfusions in preterm infants. The success of the trial relied on the participation of these parents who willingly gave informed consent for their, often very sick, premature babies to join the research project.”

Karen Willoughby, Trial Manager, explained: “These parents gave consent at such a difficult time in their lives to improve neonatal care in the future. The pool of babies who were eligible to be recruited was small and led us to spread the trial across 40 neonatal intensive care sites. Achieving the trial recruitment target ahead of predictions reflects the dedication, professionalism and sensitivity of the site team who build strong relationships with parents within the neonatal intensive care unit on a daily basis.”

The team are expecting the analysis for the primary paper to be completed next year with publication in one of the major scientific journals.

Dr Simon added “We are hoping to present the findings at meetings, including a prestigious international paediatric conference and publish our first paper in a leading medical journal. These are key steps in sharing our findings with the medical community and patient and parent groups.

“We are planning several analyses of the dataset given it provides such a unique resource – for example, whether we can help predict types of bleeding in premature babies.”

Over 40 sites across the UK and Europe took part in this research, with each site having a principal investigator and at least one research nurse.

This feature was taken from the December / January issue of Connect magazine available now in all centres!

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