Platelet transfusion: a review of key concepts

Many clinical situations involve the platelet transfusion support of patients with thrombocytopenia. Among these are patients with leukemia, oncology patients receiving chemotherapy, patients undergoing bone marrow transplantation, patients with idiopathic thrombocytopenia purpura (ITP), and the acute trauma patient. The Transfusion Medicine service plays a key role in the care of patients in that they are expected to provide quality blood products and aid in clinical decision making. Issues often encountered are the effectiveness, efficiency, and appropriateness of the products being given. This review covers the clinical consequences of thrombocytopenia, the relationship between platelet count and hemorrhage, the impact of platelet transfusion on hemostasis, the “optimal” dosage of platelets, and the importance of individualizing dosage in various common clinical scenarios.