Platelet utilization and the transfusion trigger: a prospective analysis.
BACKGROUND
Prophylactic platelet (PLT) transfusion practices have become more conservative as studies support a threshold for transfusions at 10 x 10(9) per L. This change in practice may reduce our use of PLT transfusions.


METHODS
Data were prospectively collected to assess the impact at one academic hospital when the transition from a 20 x 10(9) to a 10 x 10(9) per L threshold prophylactic transfusion was made.


RESULTS
A total of 503 patients received 7401 PLT transfusions. Seventy-four percent of the transfusions were prophylactic. During the first phase of the study, only 53 percent of transfusions were given at a pretransfusion PLT count of less than 20 x 10(9) per L and 20 percent less than 10 x 10(9) per L. In the second phase of the study when the transfusion trigger was 10 x 10(9) per L, 28 percent of transfusions were given at this level.


CONCLUSIONS
Many prophylactic PLT transfusions were given at PLT counts higher than the recommended trigger. Although the new transfusion guidelines altered transfusion practice, only a minor change in overall PLT usage was observed. Other changes in transfusion practices, such as dose per transfusion or sampling interval, will be required before significant reduction in the costs and hazards of prophylactic PLT transfusions can be realized.
Greeno
Edward
E
Department of Medicine and Laboratory Medicine, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
McCullough
Jeffrey
J
Weisdorf
Daniel
D
D000046:Academic Medical Centers / Q000592:standards / Q000706:statistics & numerical data; D001771:Blood Banks / Q000592:standards / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D010976:Platelet Count / Q000592:standards* / Q000706:statistics & numerical data; D017713:Platelet Transfusion / Q000592:standards* / Q000706:statistics & numerical data; D011446:Prospective Studies; D013921:Thrombocytopenia / Q000517:prevention & control* / Q000628:therapy