Intraarterial platelet infusion for patients with intractable gastrointestinal hemorrhage and severe refractory thrombocytopenia.
Transarterial therapies used for the treatment of acute nonvariceal gastrointestinal (GI) hemorrhage have traditionally included vasopressin infusion and embolization. However, for patients with diffuse or multifocal hemorrhage and severe refractory thrombocytopenia, these options are suboptimal because platelet counts and coagulation parameters may not be adequate to allow for the formation of a stable clot. Herein two such patients treated with direct intraarterial (IA) infusion of platelets into the vascular territory supplying the hemorrhage are described. In both patients, after IA platelet infusion, blood product requirements were immediately reduced, bleeding from the GI tract resolved by clinical and laboratory criteria, and no significant bowel ischemia was seen.
Madoff
David C
DC
Division of Diagnostic Imaging, University of Texas M D Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 325, Houston, Texas 77030-4009, USA. dmadoff@di.mdacc.tmc.edu
Wallace
Michael J
MJ
Lichtiger
Benjamin
B
Komanduri
Krishna V
KV
Ross
William A
WA
Narvios
Aida B
AB
Parmley
C Lee
CL
D000208:Acute Disease; D000328:Adult; D004621:Embolization, Therapeutic; D016145:Endoscopy, Digestive System; D017707:Erythrocyte Transfusion; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000628:therapy*; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000175:diagnosis / Q000628:therapy*