After undergoing a 12-hour liver transplant surgery, a 56-year-old man received 15 units of RBCs, 8 units of FFP, 4 units of platelets, and 500 mL of albumin. He was transferred to the intensive care unit in a stable condition but developed signs of septic shock four hours later. Broad-spectrum antibiotics were initiated.
Wrong Answer: A. Packed RBCs
Wrong Answer: B. Cryoprecipitate
Right Answer:C. Platelets Explaination Of the four blood products mentioned in this case, platelets are the most likely to cause bacterial sepsis. The incidence of platelet-related sepsis is estimated at approximately 1 in every 12,000 transfusions. The bacteria may originate from the donor’s blood or can be introduced during the collection, processing, or storage of the blood product. Unlike other blood products, which are stored at lower temperatures, platelets are kept at room temperature (20 to 24°C) to maintain their function. However, this storage condition also allows bacteria to survive and proliferate. In contrast, other blood products are stored at much lower temperatures, significantly reducing the risk of bacterial contamination. Whole blood and packed RBCs are stored at 4°C (or even frozen, depending on the storage requirement). FFP (fresh frozen plasma) and cryoprecipitate are frozen to temperatures below −70°C. Albumin, being heat sterilized, is a sterile product and can safely be stored at room temperature without the risk of bacterial contamination. Platelets are more susceptible to bacterial growth compared to other blood products because they are stored at room temperature (20-24°C), which creates an environment conducive to bacterial proliferation. Despite improvements in collection and screening processes, bacterial contamination remains the leading infectious risk associated with transfusion of platelets. The most common bacteria causing platelet transfusion-related infections are gram-positive organisms, particularly those found on the skin, such as Staphylococcus epidermidis. These bacteria can contaminate platelet units during the collection process. Strategies aimed at minimizing the risk of bacterial contamination, including improved donor screening, pathogen reduction technologies, and more sensitive bacterial detection methods are used. It is recommended to have a combination of preventive measures, such as culturing platelets before transfusion and using advanced pathogen reduction techniques, to enhance the safety of platelet transfusions. Additionally, monitoring the incidence of bacterial contamination and adopting stringent storage and handling practices can significantly reduce the risk of transfusion-related sepsis.
Clinical Pearls: ◻ Platelet-related bacterial sepsis risk: Platelets stored at room temperature (20-24°C) are more prone to bacterial contamination than other blood products stored at lower temperatures, with an estimated incidence of 1 in every 12,000 transfusions. ◻ Common bacterial contaminants: Gram-positive skin bacteria, such as Staphylococcus epidermidis, are the most frequent contaminants during the collection of platelets, leading to transfusion-related infections. ◻ Risk reduction strategies: Preventive measures include improved donor screening, advanced bacterial detection, pathogen reduction technologies, and culturing platelets before transfusion to minimize the risk of bacterial sepsis.
Wrong Answer:D. FFP
