Transfuse Platelets

Performed in Blood Bank. Order for Platelets is through a discern advisor.  The advisor will activate the Pediatric Set Up Platelet order for patients who weigh less than 40kg.
Related Tests: Blood Type

ATPLT or PTPLT

Platelet Transfusion
Platelet Pheresis
Transfuse NEO Platelets
Transfuse PEDs/PICU Platelets

The patient must have a blood type on record in the Blood Bank.  If a blood type is not available, refer to Blood Type (BTFR) for specimen collection requirements.

Blood products may be ordered with specific special instructions.  Contact Blood Bank for information on ordering Crossmatched Platelets, HLA Matched Platelets, and Reduced Volume Platelets. These special ordering instructions MUST be included on the requisition. These include the following.

• Autologous Units: Pre-donation of autologous blood must be approved by Laboratory Medical Director prior to donation and only applies if the patient previously donated their own blood for use during this hospital stay. 
• Donor Directed Units: The physician has ordered blood products be collected from friends/relatives designated specifically for use by this patient. The units must be available at the blood supplier. 
• Irradiated: If the blood product must be irradiated prior to transfusion. 

Ordering Comments, if applicable:

• Reduced Volume Platelets: Add this comment if the platelet needs to have the majority of the plasma removed. The expiration time of the unit changes to 4 hours and 2 hours of that time is required for processing. This leaves less than 2 hours to transfuse. This product must be special ordered by the Blood Bank from the blood supplier.
• Crossmatched Platelets: Add this comment if the platelets must be crossmatched. Special testing must be performed and patient sample is required.
• HLA Matched Platelets: Add this comment if the platelets must be provided as HLA (Human Leukocyte Antigen) matched. Special testing must be performed and patient sample is required for HLA matched platelets.
• Washed Platelets: Add this comment if the platelets must be washed prior to transfusion to remove donor plasma and anticoagulant.
• CMV Seronegative: Must be approved by Laboratory Medical Director.

If platelets must be ordered from the blood supplier, it will require 1 to 72 hours depending on special ordering instructions. Call the Blood Bank for information on availability.  Platelets are stored at monitored room temperature on a special agitator. The expiration date of a unit is 5 days after collection from the donor. Reduced volume and washed platelets expire 4 hours from modification. 

Transfusion:
Platelets are transfused to bleeding patients with related to low or abnormally funtioning platelets.  Transfusion volume depends on the clinical situation and the patient's size.  One unit of Apheresis Platelets would expect to increase the platelet count of a 70kg adult by 5000 to 10,000/uL and increase the count of an 18kg child by 20,000/uL.  The therapeutic adult does is 1 unit of Apheresis Platelets (equivalent to 4 to 6 units of whole-blood-derived platelets), which usually contains ≤3.0 x 10¹¹ platelets.

Leuko-reduced Platelets:
All sites use leuko-reduced platelet pheresis products. This is a better overall product, helps reduce the number of febrile transfusion reactions, and is considered CMV safe.

Pathogen Reduced Platelets:
Psoralen-treated (also known as pathogen-reduced) platelets may be provided as an equivalent to irradiated, CMV-negative platelets.

Detailed information on recommendations for transfusion can be found in the "AABB Circular of Information for the Use of Human Blood and Blood Components" located on the AABB web site (linked below).
http://www.aabb.org/tm/coi/Pages/default.aspx