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Platelet transfusions: the science behind safety, risks and appropriate applications.
1Virginia Commonwealth University Medical Center, Sanger Hall 81-007, 1101 East Marshall Street, Richmond, Virginia 23298-0695, USA. BDSpiess@HSC.VCU.EDU
Best Practice & Research. Clinical Anaesthesiology
|April 21, 2010
Summary
Stored platelets undergo changes that can lead to side effects like fever and thrombosis. While beneficial for bleeding patients, outcomes data suggest transfusions may sometimes worsen patient results, possibly due to storage alterations or overuse.
Area of Science:
- Transfusion Medicine
- Hematology
- Cellular Biology
Background:
- Platelets are vital for hemostasis, inflammation, and wound healing.
- Stored platelets undergo activation, morphological changes, and micro-particle formation.
- These storage-induced changes can lead to adverse transfusion reactions.
Purpose of the Study:
- To review the biological changes in stored platelets.
- To discuss potential side effects of platelet transfusions.
- To examine the controversial outcomes associated with platelet transfusions.
Main Methods:
- Literature review of platelet storage and transfusion outcomes.
- Analysis of biological alterations in stored platelets.
- Examination of clinical data regarding transfusion efficacy.
Main Results:
- Stored platelets exhibit partial activation, inflammatory mediator up-regulation, and apoptosis.
- Potential side effects include fever, alloimmunization, sepsis, thrombosis, and transfusion-related acute lung injury.
- Controversial outcome data suggest platelet transfusions may be associated with worse patient outcomes in some populations.
Conclusions:
- Storage-induced changes in platelets may contribute to adverse events.
- The association between platelet transfusions and poorer outcomes warrants further investigation.
- Optimizing platelet product utilization and matching is crucial for patient safety.
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