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

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.