[Platelet Concentrates - Indication, Informed Consent, Transfusion and Adverse Events].

Area of Science:

• Hematology
• Transfusion Medicine

Background:

• Platelet concentrates (PC) are crucial for managing severe thrombocytopenia or thrombocytopathy, especially in bleeding patients.
• Platelets, though acaryotic, play vital roles in immunomodulation and hemostasis.

Purpose of the Study:

• To provide a comprehensive German review comparing apheresis and whole blood-derived PC.
• To discuss indications, transfusion triggers, dosage, and potential adverse events of PC transfusion.
• To guide physicians in patient counseling, adverse event management, and selecting appropriate PC, including for refractory patients.

Main Methods:

• Review of current literature and clinical guidelines on platelet concentrate transfusion.
• Comparison of apheresis-derived and whole blood-derived platelet concentrates.
• Discussion of adverse events, prophylaxis, and practical aspects of PC transfusion.

Main Results:

• PC transfusion is a life-saving intervention for specific hematological conditions.
• Eight prevalent and severe adverse events associated with PC transfusion are detailed, along with their management and prevention strategies.
• Practical guidance, including a flowchart for refractory patients, is provided for optimal PC selection and use.

Conclusions:

• Informed consent is mandatory for PC transfusion outside emergencies, requiring physician awareness of risks and benefits.
• Understanding and managing adverse events are critical for safe and effective PC transfusion therapy.
• This review offers practical insights for physicians to optimize platelet transfusion practices.