***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A variety of patient and product-related factors influenced the outcome of 6379 transfusions given to 533 patients in the Trial to Reduce Alloimmunization to Platelets ( TRAP ) . Responses measured were platelet increments , interval between platelet transfusions , and platelet refractoriness . Patient factors that improved platelet responses were splenectomy and increasing patient age . In contrast , at least 2 prior pregnancies , male gender , splenomegaly , bleeding , fever , infection , disseminated intravascular coagulation , increasing height and weight , lymphocytotoxic antibody positivity , an increasing number of platelet transfusions , or receiving heparin or amphotericin were associated with decreased posttransfusion platelet responses . Platelet factors that were associated with improved platelet responses were giving ABO-compatible platelets , platelets stored for 48 hours or less , and giving large doses of platelets while ultraviolet B ( UV-B ) or gamma irradiation decreased platelet responses . However , in alloimmunized lymphocytoxic antibody-positive patients , the immediate increment to UV-B-irradiated platelets was well maintained , whereas all other products showed substantial reductions . Refractoriness to platelet transfusions developed in 27 % of the patients . Platelet refractoriness was associated with lymphocytotoxic antibody positivity , heparin administration , fever , bleeding , increasing number of platelet transfusions , increasing weight , at least 2 pregnancies , and male gender . The only factors that reduced platelet refractoriness rates were increasing the dose of platelets transfused or transfusing filtered apheresis platelets BACKGROUND The storage duration of platelet ( PLT ) units is limited to 5 to 7 days . This study investigates whether PLT storage duration is associated with patient outcomes in critically ill patients . STUDY DESIGN AND METHODS This study was a retrospective analysis of critically ill patients admitted to the intensive care unit ( ICU ) of two hospitals in Australia who received one or more PLT transfusions from 2008 to 2014 . Storage duration was approached in several different ways . Outcome variables were hospital mortality and ICU-acquired infection . Associations between PLT storage duration and outcomes were evaluated using multiple logistic regression and also by Cox regression . RESULTS Among 2250 patients who received one or more PLT transfusions while in the ICU , the storage duration of PLTs was available for 64 % of patients ( 1430 ) .  In-hospital mortality was 22.1 % and ICU infection rate 7.2 % . When comparing patients who received PLTs of a maximum storage duration of not more than 3 , 4 , or 5 days , there were no significant differences in baseline characteristics . After confounders were adjusted for , the storage duration of PLTs was not independently associated with mortality ( 4 days vs. ≤3 days , odds ratio [ OR ] 0.88 , 95 % confidence interval [ CI ] 0.59 - 1.30 ; 5 days vs. ≤3 days , OR 0.97 , 95 % CI 0.68 - 1.37 ) or infection ( 4 days vs. ≤3 days , OR 0.71 , 95 % CI 0.39 - 1.29 ; 5 days vs. ≤3 days , OR 1.11 , 95 % CI 0.67 - 1.83 ) . Similar results were obtained regardless of how storage duration of PLTs was approached . CONCLUSIONS In this large observational study in a heterogeneous ICU population , storage duration of PLTs was not associated with an increased risk of mortality or infection Pathogen reduction ( PR ) of platelet products increases costs and available clinical studies are equivocal with respect to clinical and haemostatic effectiveness . We conducted a multicentre , open‐label , r and omized , non‐inferiority trial comparing the clinical effectiveness of buffy‐coat derived leucoreduced platelet concentrates ( PC ) stored for up to 7 d in plasma with platelets stored in platelet additive solution III ( PASIII ) without and with treatment with amotosalen‐HCl/ultraviolet‐A ( UVA ) photochemical pathogen reduction ( PR‐PASIII ) . Primary endpoint of the study was 1‐h corrected count increment ( CCI ) . Secondary endpoints were 24‐h CCI , bleeding , transfusion requirement of red cells and PC , platelet transfusion interval and adverse transfusion reactions . Compared to plasma‐PC , in the intention to treat analysis of 278 evaluable patients the mean difference for the 1‐h CCI of PR‐PASIII‐PC and PASIII‐PC was −31 % ( P < 0·0001 ) and −9 % ( P = n.s . ) , respectively . Twenty‐seven patients ( 32 % ) had bleeding events in the PR‐PASIII arm , as compared to 19 ( 19 % ) in the plasma arm and 14 ( 15 % ) in the PASIII arm ( P = 0·034 ) . Despite the potential advantages of pathogen ( and leucocyte ) inactivation of amotosalen‐HCl/UVA‐treated platelet products , their clinical efficacy is inferior to platelets stored in plasma , warranting a critical re appraisal of employing this technique for clinical use BACKGROUND Bacterial screening offers the possibility of extending platelet ( PLT ) storage to Day 7 . We conducted a noninferiority , crossover trial comparing PLTs stored for 6 or 7 days versus 2 to 5 days . STUDY DESIGN AND METHODS Stable hematology patients were allocated to receive blocks of 2- to 5- and 6- or 7-day PLTs in r and om order . The primary outcome was the proportion of successful transfusions during the first block , defined as a corrected count increment ( CCI ) of more than 4.5 at 8 to 24 hours posttransfusion . RESULTS Of 122 patients with an evaluable first block , 87 ( 71 % ) and 84 ( 69 % ) had successful transfusions after 2- to 5- and 6- or 7-day PLTs of mean ( SD ) ages of 3.8 ( 1.0 ) and 6.4 ( 0.5 ) days , respectively . Six- or 7-day PLTs were declared noninferior to 2- to 5-day PLTs since the upper confidence interval ( CI ) limit was less than the predefined noninferiority margin of 10 % ( 95 % CI , -14.0 % to 9.1 % ; p = 0.766 ) . Logistic regression analysis gave an adjusted odds ratio of 0.86 ( 95 % CI , 0.47 - 1.58 ; p = 0.625 ) . Mean ( SD ) 8- to 24-hour CCIs were 9.4 ( 7.9 ) and 7.7 ( 7.1 ) after transfusion with 2- to 5- or 6- or 7-day PLTs ( 95 % CI , -3.31 to 0.03 ; p = 0.054 ) . The proportions of days with bleeding scores of WHO Grade 2 or higher were 13 % ( 38/297 days ) and 11 % ( 32/296 days ; 95 % CI , -3.2 to 7.2 ; p = 0.454 ) . Median interval to next PLT transfusion ( 2 days ) was unaffected ( 95 % CI , -10.5 to 5.4 ; p = 0.531 ) . CONCLUSION In hematology patients , there was no evidence that 6- or 7-day PLTs were inferior to 2- to 5-day PLTs , as measured by proportion of patients with successful transfusions , bleeding events , or interval to next transfusion BACKGROUND Blood transfusion increases the risk of nosocomial infection in trauma patients . Specific patient- and transfusion-related risk factors are largely unknown . In this study , risk factors for developing a bacterial infection after transfusion of red blood cells ( RBC ) or platelets were determined in a cohort of transfused critically ill trauma patients . MATERIAL AND METHODS A retrospective study was conducted in a mixed medical-surgical Intensive Care Unit ( ICU ) of a level-1 university trauma centre , in trauma patients who received a RBC or platelet transfusion . Patients who developed a bacterial infection after transfusion were compared to transfused controls who did not develop such an infection . Multivariable logistic regression was used to determine risk factors for infection . RESULTS Of the 7,118 patients admitted to the ICU during the study period , 196 trauma patients met the inclusion criteria . An infection developed in 56 patients ( 29 % ) . Infection occurred irrespective of the administration of antibiotics as part of selective digestive tract decontamination , surgery status or Injury Severity Score . Transfusion of RBC stored for more than 14 days was associated with infection in trauma patients ( odds ratio 1.038 , [ 95 % CI : 1.01 - 1.07 ] , p=0.036 ) . Neither the amount of RBC nor that of platelets was associated with onset of infection . CONCLUSIONS Transfusion of RBC stored for more then 14 days is a risk factor for onset of bacterial infection after trauma , irrespective of the use of prophylactic antibiotics . Transfusion of platelets was not a risk factor . These results may contribute to design ing prospect i ve studies on transfusion of fresh RBC only in trauma patients Non-r and omised studies of the effects of interventions are critical to many areas of healthcare evaluation , but their results may be biased . It is therefore important to underst and and appraise their strengths and weaknesses . We developed ROBINS-I ( “ Risk Of Bias In Non-r and omised Studies - of Interventions ” ) , a new tool for evaluating risk of bias in estimates of the comparative effectiveness ( harm or benefit ) of interventions from studies that did not use r and omisation  to allocate units ( individuals or clusters of individuals ) to comparison groups . The tool will be particularly useful to those undertaking systematic review s that include non-r and omised studies A nucleic acid-targeted photochemical treatment ( PCT ) using amotosalen HCl ( S-59 ) and ultraviolet A ( UVA ) light was developed to inactivate viruses , bacteria , protozoa , and leukocytes in platelet components . We conducted a controlled , r and omized , double-blinded trial in thrombocytopenic patients requiring repeated platelet transfusions for up to 56 days of support to evaluate the therapeutic efficacy and safety of platelet components prepared with the buffy coat method using this pathogen inactivation process . A total of 103 patients received one or more transfusions of either PCT test ( 311 transfusions ) or  conventional reference ( 256 transfusions ) pooled , leukoreduced platelet components stored for up to 5 days before transfusion . More than 50 % of the PCT platelet components were stored for 4 to 5 days prior to transfusion . The mean 1-hour corrected count increment for up to the first 8 test and reference transfusions was not statistically significantly different between treatment groups ( 13,100 + /- 5400 vs 14,900 + /- 6200 , P = .11 ) . By longitudinal regression analysis for all transfusions , equal doses of test and reference components did not differ significantly with respect to the 1-hour ( 95 % confidence interval [ CI ] , -3.1 to 6.1 x 10(9)/L , P = .53 ) and 24-hour ( 95 % CI , -1.3 to 6.5 x 10(9)/L , P = .19 ) posttransfusion platelet count . Platelet transfusion dose , pretransfusion storage duration , and patient size were significant covariates ( P < .001 ) for posttransfusion platelet counts . Clinical hemostasis , hemorrhagic adverse events , and overall adverse events were not different between the treatment groups . Platelet components prepared with PCT offer the potential to further improve the safety of platelet transfusion using technology compatible with current methods to prepare buffy coat platelet components BACKGROUND Studies in cardiac surgery have reported increased postoperative morbidity and mortality after  allogeneic red blood cell ( RBC ) transfusions .  Whether platelet ( PLT ) and /or plasma transfusions are a marker for more concomitant RBC transfusions or are independently associated with complications after cardiac surgery is unknown . STUDY DESIGN AND METHODS Data from two r and omized controlled studies were combined to analyze the effects of PLT and /or plasma transfusions on postoperative infections , length of stay in the intensive care unit ( ICU ) , all-cause mortality , and mortality in the presence or absence of infections in the postoperative period . RESULTS After adjusting for confounding factors , plasma units and not RBC transfusions were associated with all-cause mortality . White blood cell (WBC)-containing RBC transfusions and PLT transfusions were associated with mortality occurring in the presence of or after infections . The number of ( WBC-containing ) RBC transfusions was also significantly associated with postoperative infections and with ICU stay for 4 or more days . CONCLUSION Although it is difficult to separate the effects of blood components , we found that in cardiac surgery , perioperative plasma transfusions are independently associated with all-cause mortality .  WBC-containing RBC transfusions and PLT transfusions are independently associated with mortality in the presence of infections in the postoperative period . Future transf 
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Conclusions PLT storage time does not appear to be associated with clinical outcomes , including bleeding , sepsis or mortality , in critically ill patients or haematology patients .
The freshest PLTs ( less than 3 days ) were associated with a better CCI , although there was no impact on bleeding events , question ing the clinical significance of this association .
However , there is an absence of evidence to draw definitive conclusions , especially in critically ill patients