Optimizing platelet transfusion therapy. Export

@article{citeulike:1118152, abstract = {Platelet transfusions are widely used. Prophylactic transfusions are employed in severely thrombocytopenic patients without evidence of bleeding, but no randomized trial data prove the safety or efficacy of this approach. Randomized trials have demonstrated the equivalence of transfusion triggers of 10,000 and 20,000/microl for prophylactic transfusions. The former threshold is potentially safer for the patient, conservative of donor resources and leads to lower costs, with perhaps a slightly greater risk of minor hemorrhage. Randomized trials have demonstrated the equivalence of pheresis or whole blood-derived platelet transfusions. The former present a lower risk for infectious agents, and the latter are less expensive and a more efficient use of limited donor resources. Randomized trials prove that leukoreduced and ABO identical platelet transfusions reduce the risks of HLA alloimmunization and platelet transfusion refractoriness (both leukoreduction and ABO matching), transfusion reactions (leukoreduction) and CMV transmission (leukoreduction). Leukoreduction and ABO matching of platelet transfusions also have been associated in preliminary observational studies with reduced morbidity and mortality in surgical patients and reduced infections in patients with leukemia. These results require further investigation. Future challenges include (1) determining the best approach to bacterial contamination of platelets, whether by detection methods or pathogen inactivation and (2) determining the threshold for prophylactic platelet transfusions in thrombocytopenic patients undergoing surgery or invasive procedures.}, address = {Hematology-Oncology Unit, Department of Medicine, University of Rochester Medical Center, 601 Elwood Avenue, Box 608, Rochester, NY 14642, USA.}, author = {Heal, J. M. and Blumberg, N.}, citeulike-article-id = {1118152}, citeulike-linkout-0 = {http://dx.doi.org/10.1016/S0268-960X(03)00057-2}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/15183900}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=15183900}, doi = {10.1016/S0268-960X(03)00057-2}, issn = {0268-960X}, journal = {Blood Rev}, keywords = {blood, ptt, review, transfusion}, month = {September}, number = {3}, pages = {149--165}, posted-at = {2008-11-09 23:32:15}, priority = {2}, title = {Optimizing platelet transfusion therapy.}, url = {http://dx.doi.org/10.1016/S0268-960X(03)00057-2}, volume = {18}, year = {2004} }

TY - JOUR ID - citeulike:1118152 L3 - citeulike-article-id:1118152 N2 - Platelet transfusions are widely used. Prophylactic transfusions are employed in severely thrombocytopenic patients without evidence of bleeding, but no randomized trial data prove the safety or efficacy of this approach. Randomized trials have demonstrated the equivalence of transfusion triggers of 10,000 and 20,000/microl for prophylactic transfusions. The former threshold is potentially safer for the patient, conservative of donor resources and leads to lower costs, with perhaps a slightly greater risk of minor hemorrhage. Randomized trials have demonstrated the equivalence of pheresis or whole blood-derived platelet transfusions. The former present a lower risk for infectious agents, and the latter are less expensive and a more efficient use of limited donor resources. Randomized trials prove that leukoreduced and ABO identical platelet transfusions reduce the risks of HLA alloimmunization and platelet transfusion refractoriness (both leukoreduction and ABO matching), transfusion reactions (leukoreduction) and CMV transmission (leukoreduction). Leukoreduction and ABO matching of platelet transfusions also have been associated in preliminary observational studies with reduced morbidity and mortality in surgical patients and reduced infections in patients with leukemia. These results require further investigation. Future challenges include (1) determining the best approach to bacterial contamination of platelets, whether by detection methods or pathogen inactivation and (2) determining the threshold for prophylactic platelet transfusions in thrombocytopenic patients undergoing surgery or invasive procedures. IS - 3 JF - Blood Rev SN - 0268-960X AD - Hematology-Oncology Unit, Department of Medicine, University of Rochester Medical Center, 601 Elwood Avenue, Box 608, Rochester, NY 14642, USA. EP - 165 TI - Optimizing platelet transfusion therapy. VL - 18 SP - 149 KW - blood KW - ptt KW - review KW - transfusion AU - Heal, JM AU - Blumberg, N PY - 2004/09// UR - http://dx.doi.org/10.1016/S0268-960X(03)00057-2 ER -