Platelet transfusion therapy.
This article provides guidelines for the appropriate use of platelet transfusions to reduce unnecessary transfusions, thereby avoiding transfusion-related risks to the patients and the costs of platelet therapy. Platelet products available for transfusion are whole blood derived platelet concentrates and apheresis platelets. Leukoreduced platelets can be used to reduce platelet alloimmunization, cytomegalovirus transmission, and febrile transfusion reactions, while gamma irradiation prevents transfusion-associated graftversus-host disease. Other topics discussed are the expected response to transfused platelets and reasons for poor responses related to alloimmunization, underlying disease state, clinical conditions, and drugs. Appropriate transfusion guidelines based on pretransfusion platelet count, platelet dose, and whether the transfusion is prophylactic or therapeutic are outlined. Identification, prevention, and management of adverse consequences of platelet transfusions and platelet refractoriness are discussed.
Slichter
Sherrill J
SJ
Puget Sound Blood Center, 921 Terry Avenue, Seattle, WA 98104-1256, USA. sjslichter@psbc.org
D001788:Blood Grouping and Crossmatching; D001792:Blood Platelets / Q000166:cytology; D002470:Cell Survival; D006801:Humans; D010976:Platelet Count; D017713:Platelet Transfusion / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome