Abstract
AbstractTransfused platelets (plts) are either pooled random-donor platelet (plt) concentrates or single-donor apheresis plts. When stored for 5 days, all of these products are equally efficacious.A 10,000/μL prophylactic plt transfusion trigger has been documented to be both hemostatically efficacious and cost effective in reducing plt transfusion requirements. The optimal plt dose/transfusion is being evaluated in an ongoing clinical trial. Therapeutic plt transfusions to control or prevent bleeding with trauma or surgical procedures require higher transfusion triggers of 100,000/μL for neurosurgical procedures and between 50,000/μL and 100,000/μL for other invasive procedures or trauma.Leukoreduction has been documented to reduce plt alloimmunization rates, cytomegalovirus (CMV) transmission by transfusion, and febrile transfusion reactions. Whether it reduces immunomodulatory effects of transfusion (i.e., decreases infection rates and cancer recurrence) is still controversial, as is universal leukoreduction.Poor responses to plt transfusions are often multifactorial. 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. Other causes of poor plt responses are splenomegaly, ABO mismatching, females with 2 or more pregnancies and males, use of heparin or amphotericin, bleeding, fever, graft-vs-host disease (GVHD), and vaso-occlusive disease (VOD).
Publisher
American Society of Hematology
Reference40 articles.
1. Slichter SJ, Harker LA. Preparation and storage of platelet concentrates. I. Factors influencing the harvest of viable platelets from whole blood. Br J Haematol. 1976;34:395–402.
2. Pietersz RNI, Loos JA, Reesink HW. Platelet concentrates stored in plasma for 72 hours at 22°C prepared from buffy coats of citrate-phosphate-dextrose blood collected in a quadruple-bag saline-adenine-glucose-mannitol system. Vox Sang. 1985;49:81–85.
3. Keegan T, Heaton A, Holme S, et al. Paired comparison of platelet concentrates prepared from platelet-rich plasma and buffy coats using a new technique with 111In and 51Cr. Transfusion. 1992;32:113–120.
4. Cardigan R, Williamson LM. The quality of platelets after storage for 7 days. Transfus Med. 2003;13:173–187.
5. Bertolini F, Rebulla P, Riccardi D, et al. Evaluation of platelet concentrates prepared from buffy coats and stored in a glucose-free crystalloid medium. Transfusion. 1989;29:605–609.
Cited by
212 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献