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Platelet transfusion

Definition
Platelet transfusion is a therapeutic procedure that involves the infusion of platelets into a patient to manage or prevent bleeding due to low platelet counts.
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Pathophysiology
The pathophysiology of platelet transfusion revolves around the role of platelets in hemostasis. Platelets are crucial for blood clotting and maintaining hemostasis. When infused, they accumulate at the site of blood vessel injury, promote clotting, and form a hemostatic plug to prevent hemorrhage.
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Epidemiology
The incidence of platelet transfusion in hospitalized patients in the US is estimated at 0.52% in 2018Q4.
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Disease course
The clinical course following platelet transfusion involves monitoring the patient's platelet count increments and the duration of response. The corrected count increment is a measure used to evaluate the effectiveness of platelet transfusion. Factors such as splenomegaly and the use of anti-platelet drugs can influence the response to platelet transfusion.
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Prognosis and risk of recurrence
The prognosis following platelet transfusion is generally favorable with an expected increase in platelet counts and a decreased risk of bleeding. However, complications can occur, including transfusion reactions and refractoriness to platelet transfusions.
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Key sources
The following summarized guidelines for the management of platelet transfusion are prepared by our editorial team based on guidelines from the European Society of Intensive Care Medicine (ESICM 2020) and the American Association of Blood Banks (AABB 2015).
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Guidelines

1.Medical management

Indications for platelet transfusion
Transfuse platelets prophylactically to reduce the risk for spontaneous bleeding in hospitalized adult patients with therapy-induced hypoproliferative thrombocytopenia.
B
Transfuse platelets prophylactically to hospitalized adult patients with a platelet count ≤ 10×10⁹ cells/L to reduce the risk for spontaneous bleeding.
B
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2.Specific circumstances

Patients undergoing cardiopulmonary bypass
Avoid routine prophylactic platelet transfusion for patients who are not thrombocytopenic undergoing cardiac surgery with cardiopulmonary bypass.
D
Consider platelet transfusion for patients undergoing cardiopulmonary bypass who exhibit perioperative bleeding with thrombocytopenia and/or evidence of platelet dysfunction.
C

More topics in this section

  • Critically ill patients, non-bleeding