22nd July 2024

Platelet transfusion

Usual thresholds for transfusion in non-bleeding patients are platelets <10 x10⁹/L or <20 x10⁹/L in the context of sepsis. In bleeding patients, this threshold is increased to <30 x10⁹/L or higher for severe bleeding or high-risk sites, e.g. CNS bleeding. The peak increment can be measured 10-60 minutes post transfusion, and then reduces over the next 72 hours, with the expected increase to be around 30 x10⁹/L per pool of platelets transfused.

Complications include all of the transfusion reactions associated with blood transfusions (Table 4), however the most common reactions with platelet transfusion include infection (platelets are stored at room temperature so bacteria can divide rapidly) and alloimmunisation (production of anti-HLA antibodies against the donor platelets, leading to no significant increment in platelet count).