Use of platelet transfusions

Transfusion therapy of thrombocytopenia: a reappraisal

In the management of thrombocytopenia, platelet concentrated (PC) were given only to patients who had neither frank haemorrhage nor significant anaemia. Fresh whole blood (FWB) was preferred for those with the former, and platelet-rich red cell concentrate (PRC) for those with the latter complication. As a result of this approach it was found that only 6% of 412 therapy courses required PC, 37% required FWB and the remaining 57% required PRC. These are the findings of a year's survey of the requirements of patients in a predominantly urban population of approximately 1,200,000. The surprisingly high proportion of patients with complications requiring transfusion therapy, and the 24-hour availability of FWB and PRC in a metropolitan blood bank, have made PC transfusion an elective procedure and eliminated the need for a PC bank. Moreover, a better approach to treatment is available whilst a significant saving of blood donations is effected.

Effect on platelet counts and fever of platelet transfusion in leukemia

The efficacy of platelet transfusions in pretransfused HL-1 sensitized patients has been doubtful, particularly where repeated platelet transfusions were required. The efficacy of one hundred and nine ABO-compatible, cross match negative platelet transfusions in 26 adult patients with acute leukemia was therefore studied. Although most of the patientswere old and pretransfused and although no HL-A typing could be made, a statistically significant average increase of about 11 000 platelets/mul was seen not only after the first but also after subsequent (up to 8) platelet transfusions. Moreover, significant reduction in temperature followed platelet transfusions. However, platelet recoveries were worse in severely infected patients.