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ToolsMoore, Carmel Maria, D'Amore, Angela, Fustolo-Gunnink, Suzanne, Hudson, Cara, Newton, Alice, Santamaria, Beatriz Lopez, Deary, Alison, Hodge, Renate, Hopkins, Valerie, Mora, Ana, Llewelyn, Charlotte, Venkatesh, Vidheya, Khan, Rizwan, Willoughby, Karen, Onland, Wes, Fijnvandraat, Karin, New, Helen V., Clarke, Paul, Lopriore, Enrico, Watts, Timothy, Stanworth, Simon and Curley, Anna and PlaNeT2 MATISSE Collaborators (2023) Two-year outcomes following a randomised platelet transfusion trial in preterm infants. Archives of Disease in Childhood-Fetal and Neonatal Edition, 108 (5). pp. 452-457. ISSN 1359-2998
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Abstract
Objective: Assess mortality and neurodevelopmental outcomes at 2 years of corrected age in children who participated in the PlaNeT-2/MATISSE (Platelets for Neonatal Transfusion - 2/Management of Thrombocytopenia in Special Subgroup) study, which reported that a higher platelet transfusion threshold was associated with significantly increased mortality or major bleeding compared to a lower one. Design: Randomised clinical trial, enrolling from June 2011 to August 2017. Follow-up was complete by January 2020. Caregivers were not blinded; however, outcome assessors were blinded to treatment group. Setting: 43 level II/III/IV neonatal intensive care units (NICUs) across UK, Netherlands and Ireland. Patients: 660 infants born at less than 34 weeks' gestation with platelet counts less than 50×109/L. Interventions: Infants were randomised to undergo a platelet transfusion at platelet count thresholds of 50×109/L (higher threshold group) or 25×109/L (lower threshold group). Main outcomes measures: Our prespecified long-term follow-up outcome was a composite of death or neurodevelopmental impairment (developmental delay, cerebral palsy, seizure disorder, profound hearing or vision loss) at 2 years of corrected age. Results: Follow-up data were available for 601 of 653 (92%) eligible participants. Of the 296 infants assigned to the higher threshold group, 147 (50%) died or survived with neurodevelopmental impairment, as compared with 120 (39%) of 305 infants assigned to the lower threshold group (OR 1.54, 95% CI 1.09 to 2.17, p=0.017). Conclusions: Infants randomised to a higher platelet transfusion threshold of 50×109/L compared with 25×109/L had a higher rate of death or significant neurodevelopmental impairment at a corrected age of 2 years. This further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants. Trial registration number: ISRCTN87736839.
| Item Type: | Article |
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| Additional Information: | Funding: This work was supported by the National Health Service Blood and Transplant Research and Development Committee (reference number BS06/1); Sanquin Research, Amsterdam (grant PPOC-12-012027); Addenbrooke’s Charitable Trust; the Neonatal Breath of Life Fund 9145; the National Institute for Health Research Clinical Research Network; the National Maternity Hospital Foundation and the Health Service Executive. |
| Uncontrolled Keywords: | neonatology,child development,intensive care units,neonatal,birth-weight infants,neonatal intensive-care,necrotizing enterocolitis,survival,intensive care units, neonatal,obstetrics and gynaecology,pediatrics, perinatology, and child health ,/dk/atira/pure/subjectarea/asjc/2700/2729 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > School of Health Sciences Faculty of Medicine and Health Sciences > Norwich Medical School |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 22 Mar 2023 10:30 |
| Last Modified: | 13 Feb 2025 01:45 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/91652 |
| DOI: | 10.1136/archdischild-2022-324915 |
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