What should I check before platelet transfusion?
What should I check before platelet transfusion?
The clearest indication for platelet transfusion is the presence of serious bleeding in the setting of severe thrombocytopenia or platelet dysfunction. A strategy of transfusing only those patients with evidence of bleeding is called a therapeutic as opposed to a prophylactic strategy.
What is refractoriness to platelet transfusion?
Platelet transfusion refractoriness is the repeated failure to achieve the desired level of blood platelets in a patient following a platelet transfusion. The cause of refractoriness may be either immune or non-immune.
How should platelets be administered?
Administer via a volumetric pump or syringe driver to ensure accurate volume delivered. Standard 170-200 micron filter either in-line or on transfer to syringe. Use a new blood administration filter (170 – 200 micron) when administering platelets.
How to diagnose and treat platelet transfusion refractoriness?
When faced with a new patient, we often begin with a screening test that confirms the presence of HLA or HPA antibodies. At our institution we use a standard enzyme-linked immunosorbent assay that is rapid and, if negative, will save the time and expense needed for a full refractory workup.
What causes refractoriness to the HLA class I antigen?
•Alloimmune platelet refractoriness almost always results from the production of antibodies to HLA Class I antigens on the platelet surface, •Antibodies to platelet specific antigens (HPA) have been described as a cause for refractoriness to platelet transfusion Human platelet antigen (HPA) system
How are PLTS used in platelet transfusions?
For alloimmune plt refractoriness, HLA matching, cross-matching, and identification of the specificity of the patient’s antibodies with avoidance of mismatched donor antigens are all equally effective in identifying compatible plts for transfusion.
When to use a platelet transfusion in thrombocytopenia?
Therapeutic plt transfusions in patients with chronic thrombocytopenia are usually indicated when bleeding is ≥ WHO grade 2.