How I use platelet transfusions

Platelet transfusions are commonly administered for the prevention or treatment of bleeding in patients with acquired thrombocytopenia across a range of clinical contexts. Recent data, including randomized trials, have highlighted uncertainties in the risk-benefit balance of this therapy, which is t...

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Bibliographic Details
Published in:Blood Vol. 140; no. 18; p. 1925
Main Authors: Stanworth, Simon J, Shah, Akshay
Format: Journal Article
Language:English
Published: United States 03.11.2022
Subjects:
Blood Platelets
Hemorrhage - etiology
Hemorrhage - prevention & control
Humans
Platelet Count
Platelet Transfusion - adverse effects
Thrombocytopenia - etiology
Thrombocytopenia - therapy
ISSN:1528-0020, 1528-0020
Online Access:Get more information
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Summary:Platelet transfusions are commonly administered for the prevention or treatment of bleeding in patients with acquired thrombocytopenia across a range of clinical contexts. Recent data, including randomized trials, have highlighted uncertainties in the risk-benefit balance of this therapy, which is the subject of this review. Hemovigilance systems report that platelets are the most frequently implicated component in transfusion reactions. There is considerable variation in platelet count increment after platelet transfusion, and limited evidence of efficacy for clinical outcomes, including prevention of bleeding. Bleeding events commonly occur despite the different policies for platelet transfusion prophylaxis. The underlying mechanisms of harm reported in randomized trials may be related to the role of platelets beyond hemostasis, including mediating inflammation. Research supports the implementation of a restrictive platelet transfusion policy. Research is needed to better understand the impact of platelet donation characteristics on outcomes, and to determine the optimal thresholds for platelet transfusion before invasive procedures or major surgery (eg, laparotomy). Platelet transfusion policies should move toward a risk-adapted approach that does not focus solely on platelet count.
Bibliography:ObjectType-Article-2
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ISSN:1528-0020
1528-0020
DOI:10.1182/blood.2022016558