From the Guidelines
The most common type of platelet infusion is single-donor platelets produced by apheresis, also known as single-donor apheresis platelets. These platelets are collected from a single donor using a blood-cell separator centrifugation system, which separates the platelets and returns the plasma and red blood cells to the donor. A standard adult dose of single-donor apheresis platelets typically contains the number of platelets equivalent to six to nine units of platelet concentrates prepared from whole blood 1. Single-donor apheresis platelets are preferred in specific situations, such as for HLA-matched transfusions or when reducing donor exposure is critical. However, random donor platelets, also known as pooled platelets, are also commonly used and are collected from multiple donors and combined to create a single therapeutic dose. Typically, a standard adult dose consists of 4-6 units pooled together, providing approximately 3 x 10^11 platelets per dose. Random donor platelets are transfused to prevent or treat bleeding in patients with thrombocytopenia (low platelet count) or platelet dysfunction. The infusion is usually administered over 15-30 minutes through a standard blood filter. Patients generally receive one adult dose for every 10kg of body weight, with the goal of increasing the platelet count by 30,000-60,000/μL. These platelets have a shelf life of only 5 days at room temperature under constant agitation, which helps maintain their function. Some key points to consider when deciding between single-donor apheresis platelets and random donor platelets include:
- The availability and cost of the platelets
- The specific clinical situation and the patient's needs
- The risk of transfusion-transmitted infections and the need to reduce donor exposure
- The potential for HLA-matched transfusions and the need to minimize the risk of alloimmunization. It's worth noting that the AABB recommends transfusing up to a single apheresis unit or equivalent, and that greater doses are not more effective, and lower doses equal to one half of a standard apheresis unit are equally effective 1. Additionally, the AABB suggests prophylactic platelet transfusion for patients having elective central venous catheter placement with a platelet count less than 20 × 10^9 cells/L, and for patients having elective diagnostic lumbar puncture with a platelet count less than 50 × 10^9 cells/L 1. Overall, the choice between single-donor apheresis platelets and random donor platelets depends on the specific clinical situation and the patient's needs, and should be made in consultation with a healthcare professional.
From the Research
Types of Platelet Infusion
- Platelet transfusions can be given as pooled random-donor platelet concentrates or single-donor apheresis platelets 2, 3.
- Both types of platelet products are indicated to treat acute hemorrhage secondary to thrombocytopenia or to provide prophylaxis from hemorrhage in patients with bone marrow aplasia 2.
Most Common Type of Platelet Infusion
- The most common type of platelet infusion is not explicitly stated in the provided studies, but it can be inferred that both pooled random-donor platelet concentrates and single-donor apheresis platelets are commonly used 2, 3.
- A study from 2001 suggests that single-donor apheresis platelets may offer major advantages over pooled random-donor platelet concentrates in terms of reducing infectious complications, transfusion reaction rates, and alloimmunization 2.
Platelet Transfusion Guidelines
- The recommended indication for prophylactic transfusion is a platelet count of 10,000/microL 4.
- Therapeutic platelet transfusions to control or prevent bleeding with trauma or surgical procedures require higher transfusion triggers of 100,000/microL for neurosurgical procedures and between 50,000/microL and 100,000/microL for other invasive procedures or trauma 3.
- Leukoreduction has been documented to reduce platelet alloimmunization rates, cytomegalovirus (CMV) transmission by transfusion, and febrile transfusion reactions 3.