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Higher platelet transfusion thresholds have been used in premature neonates, but this has been based on limited evidence. [19] There is now evidence that using a high platelet count threshold (50 x 10 9 /L) increases the risk of death or bleeding compared to a lower platelet count threshold (25 x 10 9 /L) in premature neonates. [20]
In a typical set of rules, a platelet donor must weigh at least 50 kg (110 lb) and have a platelet count of at least 150 x 10 9 /L (150,000 platelets per mm³). [2] One unit has greater than 3×10 11 platelets. Therefore, it takes 2 liters of blood having a platelet count of 150,000/mm³ to produce one unit of platelets.
On rare occasions, blood products are contaminated with bacteria. This can result in a life-threatening infection known as transfusion-transmitted bacterial infection. The risk of severe bacterial infection is estimated, as of 2020, at about 1 in 2,500 platelet transfusions, and 1 in 2,000,000 red blood cell transfusions. [44]
Platelet transfusion is contraindicated in thrombotic thrombocytopenic purpura (TTP), as it fuels the coagulopathy. Platelet transfusion is generally ineffective, and thus contraindicated, for prophylaxis in immune thrombocytopenia (ITP), because the transfused platelets are immediately cleared; however, it is indicated to treat bleeding. [70]
If antigen negative platelets are unavailable, then standard neonatal platelet transfusions should be given until antigen negative platelets become available. [20] [19] If a platelet transfusion is not available immediately then the infant can be given IVIG (1g/kg) however, this will have no effect on the platelet count before 24 to 72 hours. [19]
Different triggers for fresh frozen plasma may have little to no effect on major bleeding within 24 hours and serious adverse events measured by plasma transfusion-related complications within 24 hours. Furthermore, different triggers for fresh frozen plasma may reduce the number of individuals requiring a transfusion within 7 days. [14]
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The single unit policy is helpful in platelet transfusion as there this blood component has a short shelf-life than other components. Assessment after one bag can include assessing clinical bleeding, platelet count looking at the post transfusion increment and/or functional platelet assessments.
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