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.
机构:
Royal Melbourne Hosp, Dept Diagnost Haematol, Parkville, Vic 3050, AustraliaSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Gilbertson, M. P.
Borosak, M. E.
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Australian Red Cross Blood Serv, S Melbourne, Vic 3205, Australia
Chair Patient Blood Management Working Grp, Blood Matters Program, Dept Hlth, S Melbourne, Vic 3205, AustraliaSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Borosak, M. E.
Wood, E. M.
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机构:
Royal Melbourne Hosp, Dept Diagnost Haematol, Parkville, Vic 3050, Australia
Australian Red Cross Blood Serv, S Melbourne, Vic 3205, AustraliaSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
机构:
Med Univ Vienna, Internal Dept 1, A-1090 Vienna, AustriaSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Rabitsch, W.
Ay, C.
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Med Univ Vienna, Internal Dept 1, A-1090 Vienna, AustriaSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Ay, C.
Lambermont, M.
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Belgian Red Cross, Serv Sang, B-1180 Brussels, BelgiumSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Lambermont, M.
Deneys, V.
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Belgian Red Cross, Serv Sang, B-1180 Brussels, BelgiumSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Deneys, V.
Sondag, D.
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Belgian Red Cross, Serv Sang, B-1180 Brussels, BelgiumSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Sondag, D.
Compernolle, V.
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机构:Sanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Compernolle, V.
Legrand, D.
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机构:
Univ Grenoble 1, CNRS, Equipe Therex, UMR 5525, F-38700 La Tronche, FranceSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Legrand, D.
Francois, A.
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机构:
Univ Grenoble 1, CNRS, Equipe Therex, UMR 5525, F-38700 La Tronche, FranceSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Francois, A.
Tardivel, R.
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机构:
Univ Grenoble 1, CNRS, Equipe Therex, UMR 5525, F-38700 La Tronche, FranceSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Tardivel, R.
Garban, F.
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机构:
Univ Grenoble 1, CNRS, Equipe Therex, UMR 5525, F-38700 La Tronche, FranceSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Garban, F.
Sawant, R. B.
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机构:
Rajkot Voluntary Blood Bank & Res Ctr, Rajkot, Gujarat, IndiaSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Sawant, R. B.
Rebulla, P.
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Fdn Ca Granda Osped Maggiore Policlin, Ctr Transfus Med Cellular Therapy & Cryobiol, I-20122 Milan, ItalySanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands
Rebulla, P.
Handa, M.
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机构:
Keio Univ, Sch Med, Ctr Blood Transfus Med & Cell Therapy, Shinjuku Ku, Tokyo 1608582, JapanSanquin Blood Bank NW Reg, NL-1006 CX Amsterdam, Netherlands