Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality

Abstract

Key Points Platelet transfusions are frequently administered to hospitalized patients with platelet consumptive/destructive disorders such as TTP, HIT, and ITP. Platelet transfusions are associated with higher odds of arterial thrombosis and mortality among TTP and HIT patients.

Heparin-Induced Thrombocytopenia

“…The risk of bleeding is very low, and such transfusions can increase the risk of thrombosis. 49 A r e a s of Uncerta int y Whereas in vitro data suggest that dabigatran, rivaroxaban, and apixaban might also be used to treat patients with HIT, 50 more data are needed before these drugs can be recommended in the context of acute HIT. A concern is whether trough levels are sufficient to prevent thrombin generation by strongly reactive anti-PF4-heparin antibodies.…”

Egészségügyi szakmai irányelv – A thromboticus thrombocytopeniás purpura (TTP) és a haemolyticus uraemiás syndroma (HUS) kezeléséről

“…Számos publikáció a kórkép progresszióját, a mortalitás növekedését észlelte thrombocytatranszfúziót követően [47], míg más tanulmá-nyok nem találtak ilyen összefüggést [48]. A jelenlegi, széles körben elfogadott nézet szerint thrombocytatranszfúzió csak vitalis indikációval, súlyos vérzés esetén [10] jöhet szóba TTP-ben.…”

Alternatives to allogeneic platelet transfusion

“…DDAVP Svensson et al (2014) In clinical use largely outside the setting of thrombocytopenia. It is also important to consider that non-bleeding patients with chronic bone marrow failure do not benefit from prophylactic platelet transfusion (Padhi et al, 2015) and platelet transfusion may be harmful in the setting of thrombotic thrombocytopenic purpura and heparin-induced thrombocytopenia (Goel et al, 2015). Fibrinogen concentrate Larsen et al (2013) In clinical use largely outside the setting of thrombocytopenia.…”