Platelet Transfusion

Aka: Platelet Transfusion, Plateletpheresis Unit, Platelet Apheresis Unit, Plateletpheresis Transfusion

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II. Pathophysiology

  1. Spontaneous endothelial bleeding does not occur until Platelet Count drops to less than 5000

III. Indications: Adults

  1. Platelet Count <100,000
    1. Ocular surgery (no active bleeding)
    2. Neurosurgery (no active bleeding)
  2. Platelet Count <50,000
    1. Major elective surgery (not neurosurgery)
    2. Invasive procedure
    3. Elective diagnostic Lumbar Puncture
  3. Platelet Count <20,000
    1. Fever (over 100.4 F) in an otherwise stable, non-bleeding patient
    2. Central Venous Catheter Placement
  4. Platelet Count <10,000
    1. Stable, non-bleeding patient with hypoproliferative Thrombocytopenia

IV. Indications: Newborns

  1. Platelet Count 30,000 to 50,000
    1. Birth weight <1000 g and first week of life
    2. Cerebral Hemorrhage
    3. Coagulation Disorder
    4. Sepsis
    5. Invasive procedure
    6. Alloimmune neonatal Thrombocytopenia
      1. Directed donation with washed and irradiated products
  2. Platelet Count 20,000 to 30,000
    1. Active bleeding
    2. Lumbar Puncture
  3. Platelet Count <20,000
    1. Stable, non-bleeding patient

V. Labs

  1. Platelet Count
    1. Adults: One apheresis unit (6 pack) increases Platelets 30,000/ul to 40,000/ul per 2.0 m2 BSA
    2. Newborns: 5-10 ml/kg increases Platelets 50-100,000

VI. Adverse Effects

  1. See Transfusion Complication
  2. See Transfusion-Related Acute Lung Injury (TRALI)

VII. References

  1. Liumbruno (2009) Blood Transfus 7(2): 132-50 [PubMed]
  2. Raval (2020) Am Fam Physician 102(1):30-8 [PubMed]
  3. Sharma (2011) Am Fam Physician 83(6): 719-24 [PubMed]

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