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body surface area Can use estimate of 3 x 10 11 platelets for an - - PowerPoint PPT Presentation
body surface area Can use estimate of 3 x 10 11 platelets for an - - PowerPoint PPT Presentation
CCI less than 5,000-7,500 or PPR less than 20% at 1 hour CCI requires platelet count of the infused product as well as body surface area Can use estimate of 3 x 10 11 platelets for an apheresis unit Defining platelet refractoriness
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- CCI less than 5,000-7,500 or PPR less than 20% at 1 hour
- CCI requires platelet count of the infused product as well as
body surface area
- Can use estimate of 3 x 1011 platelets for an apheresis
unit
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- Defining platelet refractoriness
- Integrating tiered laboratory data for patient
management
- Describe the Hopkins Transfusion Coordinator
Service (a.k.a. the PLT service)
- Current challenges
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Non-Immune causes Immune causes Fever HLA antibodies Infection/sepsis HPA antibodies Disseminated intravascular coagulation ABO incompatibility Sequestration (e.g., splenomegaly) Medications Bleeding Veno-occlusive disease Graft versus host disease
Non-immune causes much more common than immune causes
(non-immune factors present in 72-88% of cases and
HLA antibodies present in 25-39%)
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- Shortened platelet survival:
- No increment:
www.uptodate.com
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Jackman, RP., et al. "Low-level HLA antibodies do not predict platelet transfusion failure in TRAP study participants." Blood 121.16 (2013): 3261-3266.
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- Pooled random
donor
- UVB irradiated
- Filtered
(leukoreduced) platelet concentrate (RDP)
- Filtered
(leukoreduced) unmatched apheresis
TRAP Trial Study Group. "Leukocyte-reduction and UV-B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusion." N Eng J Med 337 (1997): 186.
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- Defining platelet refractoriness
- Causes & Epidemiology
- Integrating tiered laboratory data for patient
management
- Describe the Hopkins Transfusion Coordinator
Service (a.k.a. the PLT service)
- Current challenges
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Sensitivity for detecting anti-HLA antibodies:
Flow cytometry > ELISA > cytotoxicity
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Kopko, PM., et al. "Methods for the selection of platelet products for alloimmune‐refractory patients." Transfusion 55.2 (2015): 235-244.
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Kopko, PM., et al. "Methods for the selection of platelet products for alloimmune‐refractory patients." Transfusion 55.2 (2015): 235-244.
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Kopko, PM., et al. "Methods for the selection of platelet products for alloimmune‐refractory patients." Transfusion 55.2 (2015): 235-244.
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Kopko, PM., et al. "Methods for the selection of platelet products for alloimmune‐refractory patients." Transfusion 55.2 (2015): 235-244.
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- HLA & HPA
- Used by some when
HLA testing is in process
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Hod, Eldad, and Joseph Schwartz. "Platelet transfusion refractoriness." British journal of haematology 142.3 (2008): 348-360.
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Hod, Eldad, and Joseph
- Schwartz. "Platelet
transfusion refractoriness." British journal of haematology 142.3 (2008): 348-360.
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- Defining platelet refractoriness
- Causes & Epidemiology
- Integrating tiered laboratory data for patient
management
- Describe the Hopkins Transfusion Coordinator
Service (a.k.a. the PLT service)
- Current challenges
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Fuller, AK., et al. "A comprehensive program to minimize platelet outdating." Transfusion 51.7 (2011): 1469-1476.
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Fuller, AK., et al. "A comprehensive program to minimize platelet outdating." Transfusion 51.7 (2011): 1469-1476.
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Fuller, AK., et al. "A comprehensive program to minimize platelet outdating." Transfusion 51.7 (2011): 1469-1476.
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- Defining platelet refractoriness
- Causes & Epidemiology
- Integrating tiered laboratory data for patient
management
- Describe the Hopkins Transfusion Coordinator
Service (a.k.a. the PLT service)
- Current challenges
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678-993-6251
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