Platelets are often irradiated to inactivate residual lymphocytes and prevent transfusion-associated graft-vs-host disease. As irradiated platelets are widely used, researchers performed a formal assessment of the quality of data and performed a meta-analysis comparing irradiated to non-irradiated platelets. Forty-four studies comparing irradiated to non-irradiated platelets were identified—41 with in vitro platelet storage data, two comparing transfusions in healthy volunteers, and one in thrombocytopenic patients. The quality and effectiveness of irradiated and non-irradiated were similar for pre-transfusion makers and post-transfusion clinical outcomes. Although not clinically meaningful, the pH of irradiated platelets was lower and P-selectin was higher on day 7 of storage compared to non-irradiated platelets (high and moderate certainty of evidence, respectively). No differences were found between supernatant glucose levels, post-transfusion bleeding risk, or platelet survival time (with moderate to low certainty of evidence). The results of the meta-analysis align with the 2017 Joint United Kingdom Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC) summary on the effect of irradiation on platelet function. Thirty-eight of 44 studies exclusively used gamma irradiation, so further randomized clinical trials that assess platelets irradiated with x-ray irradiation are needed as are further studies in patient populations.
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