Platelet transfusion

Indications

• Platelet cut-off of 50 is reasonable for invasive procedures - give 1 unit and assess response

Components available

• Apheresis: 280 x10^9 in 210mL
  • Collected from a single donor by using an apheresis machine with an integrated leucoreduction system, then returns the remaining blood back to the donor
  • Have higher residual plasma content
  • Much more costly
  • Indications:
    • Requirement for HLA compatible and/or HPA matched platelets
    • Patients who require IgA deficient platelets
    • Neonates/small children whose platelet dose requirement can be met by a split apheresis component, to avoid wastage of part of a pooled bag
• Pooled: 290 x 10^9 in 370mL
  • Produced via the Buffy Coat method - pooled from separate ABO-identical whole blood donations using a platelet additive solution, then centrifuged, filtered and rested to produce a leucodepleted pooled platelet unit
• Paed: 75 x 10^9 in 55mL

Administration

• Expected rise in a 70kg stable adult is 20-40 x 10^9/L
• Give over 30 mins
• In an adult, generally give 1 unit pooled (or apheresis if they have a specific indication)