An adult dose of pooled platelets are obtained from a pool of buffy coats from four donors. These are pooled and re-suspended in PAS to create one unit of pooled platelets.
Certain patient groups may require pooled platelets as the first choice. The ratio of plasma to platelets is less in pooled components than apheresis products and therefore the exposure to plasma is less. This becomes significant for those patient groups who have mild — moderate allergic reaction to apheresis platelets. If ABO compatible components are unavailable, patient age, weight, diagnosis and component availability pooled vs apheresis will influence the blood banks decision about what product to supply.
An ABO incompatible platelet transfusions group O platelets given to a group A patient may be associated with clinically significant transfusion reactions, including a positive DAT, red cell haemolysis and even lower platelet survival in some patients.
Platelet components contain a small number of red cells that could be Rh incompatible with the recipient. Therefore RhD negative females with childbearing potential should receive platelet transfusions from RhD negative donors. If transfusion of RhD positive product to RhD negative recipient is unavoidable, consider giving Rhesus immunoglobulin Discuss with haematologist-on-call. Clinical situation to trigger platelet transfusion.
These patients should receive platelet transfusions with clinically significant bleeding only. Clinical situation to trigger platelet transfusion in neonates. Term or preterm infant with symptomatic thrombocytopenia and minor bleeding, coagulopathy or prior to surgery.
Term or preterm infant with symptomatic thrombocytopenia and major bleeding or requiring major surgery e. Where possible, a platelet product compatible with both donor and recipient should be used. At RCH the platelet product choice for each transplant recipient will be specified by their transplant physician and will be listed on the Transplant Protocol.
Platelet transfusion in rare congenital platelet disorders such as Bernard-Soulier syndrome, Glanzmann's thrombasthenia, thrombocytopenia with absent radii TAR , Wiskott-Aldrich syndrome, Fanconi anaemia, amegakaryocytic thrombocytopenia can provoke the development of multi-specific HLA or platelet specific antibodies and they should be used sparingly.
They should be reserved for clinical bleeding or prior to invasive procedures with a high risk of bleeding.
Donor exposure should be limited through the use of apheresis platelets and the risk of alloimmunisation reduced through the use of leukocyte reduced products. The nurses will check you for any reactions. They will stop the transfusion and quickly treat any symptoms.
Tell your nurse straight away if you feel unwell during your transfusion. Rarely, if you have had lots of platelet transfusions, your platelet count may not improve after a transfusion. This is called becoming refractory or resistant to platelets. If this happens, you will have tests to find the cause.
You may be given platelets that are better matched to your own. Some people worry that the platelets they are given may be infected by disease. People who donate blood or platelets are carefully screened for infections or viruses such as hepatitis or HIV. This is to make sure the donations are as safe as possible. All donated platelets are tested in the laboratory for infection.
Very rarely, there may be an infection in the platelets that is not found by these tests. But the risk of being given infected platelets is very small. If you have any concerns about receiving a platelet transfusion, talk to your doctor or specialist nurse.
Irradiated blood products lower the risk of the donated cells reacting against your own. The radiation will not damage the blood product or make you radioactive. Your doctor will record in your medical notes if you should only have irradiated blood products. They will also give you a special card to carry, in case you are treated at another hospital. Keep this card with you at all times and remind your hospital team that you need irradiated blood or platelets.
Below is a sample of the sources used in our supportive treatment information. If you would like more information about the sources we use, please contact us at cancerinformationteam macmillan. Clinical and laboratory aspects of platelet transfusion therapy. It has been reviewed by expert medical and health professionals and people living with cancer. Platelet transfusions. Platelets are cells that help to stop bleeding.
Some cancers or cancer treatments can lead to low platelets and you may need a platelet transfusion. On this page. What are platelets? A low platelet count can increase your risk of bleeding. What is a platelet transfusion? Why do I need a platelet transfusion? Signs of a low platelet count include: nosebleeds heavy periods bruising tiny blood spots under the skin petechiae bleeding gums. Tell your doctor straight away if you notice any of these symptoms. Increasing the dose from an intermediate to a high dose did not increase the transfusion interval in two out of three studies that reported this median 5 days for both regimens.
One study reported on transfusion reactions. A systematic review identified three RCTs that compared different platelet transfusion thresholds in patients with haematological malignancies No randomised studies in adult patients have assessed the use of other transfusion thresholds, such as platelet mass, absolute immature platelet number or immature platelet fraction.
Neonates admitted to the neonatal intensive care unit NICU frequently become thrombocytopenic and intracranial haemorrhage ICH is a major concern. Guidelines directing neonatal platelet transfusion practice vary considerably, and are generally consensus rather than evidence-based.
One small pilot RCT has compared a platelet mass versus platelet count regimen and found no difference in the number of bleeding events There are two ongoing trials assessing different platelet transfusion thresholds 24, There is little evidence for the effectiveness of platelet transfusions or the optimal dose when a person with thrombocytopenia is actively bleeding.
Current recommendations are based on consensus guidelines from around the world and are dealt with in [ISBT section on major haemorrhage]. E-mail Oxford, UK. The content of this resource has been developed and reviewed by members of the ISBT Clinical Transfusion Working Party and should be used at the discretion of healthcare professionals utilising this clinical resource. The authors or the International Society of Blood Transfusion cannot accept legal responsibility for the content of this resource.
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To find out more about the cookies we use, see our Privacy Policy. A single cookie will be used in your browser to remember your preference not to be tracked. Clinical Transfusion. Reference List. Why has demand for platelet components increased? A review. Estcourt L. Transfusion Medicine. The EBMT activity survey: Bone Marrow Transplant. Evaluation of platelet transfusion triggers in a tertiary-care hospital.
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