Comparative analysis of post-transfusion increment in platelet counts in patients receiving single donor platelets by apheresis versus random donor platelets

Objectives: Platelet transfusions are essential for managing thrombocytopenia and bleeding disorders, with single donor platelets (SDP) and random donor platelets (RDP) being the primary products available. While SDPs are often preferred for their reduced donor exposure and theoretically superior outcomes, evidence comparing their post-transfusion increments remains inconclusive. This study aims to compare post-transfusion platelet count increments between patients receiving SDPs versus RDPs. Material and Methods: This study included 256 platelet transfusions (97 SDP, 159 RDP). Post-transfusion platelet counts were measured at 6 and 24 h. Absolute count increment (ACI), corrected count increment (CCI), and percentage platelet recovery (PPR) were calculated. Statistical analysis included paired and unpaired t -tests for comparing outcomes between and within groups, with secondary analysis of increment efficacy across different clinical diagnoses. Results: The mean pre-transfusion platelet counts were 39,226 ± 28,412/μL for SDP and 37,849 ± 27,921/μL for RDP ( P = 0.708). ACI at 24 h was significantly higher in the SDP group (44,286 ± 23,982/μL) compared to the RDP group (23,491 ± 17,623/μL; P < 0.001). However, when adjusted for body surface area and number of platelets transfused, CCI showed no significant difference between SDP (17,180 ± 7,918) and RDP (16,095 ± 7,356; P = 0.285). PPR was also comparable between SDP (46.54 ± 19.82%) and RDP (42.49 ± 20.13%; P = 0.117). Clinical conditions including chronic liver disease, extensive burns, and severe infections were associated with poor increments regardless of product type. Conclusion: While SDPs provide significantly higher ACIs, the efficiency as measured by CCI and PPR is comparable between SDPs and RDPs when appropriately dosed. This finding challenges the preference for SDPs based solely on increment considerations. The choice should be guided by patient-specific factors, resource availability, and cost considerations rather than expected increments alone.