Clinical perspectives of platelet transfusions: Defining the optimal dose

✍ Scribed by Ronald G. Strauss

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 397 KB
• Volume: 10
• Category: Article
• ISSN: 0733-2459
• DOI: 10.1002/jca.2920100305

✦ Synopsis

To halt bleeding in patients with severe thrombocytopenia due to bone marrow failure, it is desirable to achieve a post-transfusion blood platelet count of 40 X 109/L by platelet transfusions. Based on calculations of corrected count increments, each 1 X 10" platelets transfused will increase the blood platelet count approximately 10 X IO'/L per each square meter of patient body surface area. Thus, the post-transfusion blood platelet count will be approximately 20 X 109/L following transfusion of 3 X 10" platelets to a 5 foot, 8 inch patient weighing 170 pounds (2.0 m'), who is bleeding because of a pre-transfusion platelet count of 5 X I09/L. The post-transfusion platelet count likely will be even lower in sick patients (sepsis, amphotericin B plus antibiotic therapy, splenomegaly, graft-vs.-host disease, etc.) or if platelets are lost from the unit by leukofiltration before transfusion. Although a dose of 3 X 10" platelets is acceptable, in a regulatory sense for product quality, it is inadequate to control bleeding in most thrombocytopenic adult patients. Adjusting dose for body size, bleeding patients with pre-transfusion blood platelet of 120 pounds should receive approximately 6 X 10" platelets, those weighing 30 to 120 pounds should receive 3 X 10" platelets, and infants weighing <30 pounds (15 kg) should receive 5-10 ml/kg of platelet concentrate.