Rate of Transfusion for Random Donor Platelets (RDP)
Random donor platelets should be transfused over 30 minutes to 1 hour per unit, with a typical adult dose of 4-6 units of pooled random donor platelets transfused over approximately 2-4 hours total. 1
Standard Transfusion Rate
Each unit of random donor platelet concentrate should be infused as rapidly as tolerated by the patient, typically over 30-60 minutes per unit. 1
A typical adult prophylactic transfusion consists of 4-6 units of pooled random donor platelets, which translates to a total infusion time of approximately 2-4 hours for the complete dose. 1
Random donor platelets contain approximately 7.5 × 10^10 platelets per unit and should increase the platelet count by 5-10 × 10^9/L per unit in a 70 kg recipient. 1
Clinical Context for Dosing
The interval between prophylactic transfusions in patients with acute leukemia is typically every 2-4 days, which can usually be accomplished with 4-6 units of pooled concentrates per transfusion in average-sized adults. 1
Larger doses may be needed to achieve higher platelet counts in patients who are actively bleeding or require invasive procedures. 1
For therapeutic transfusions (treating active bleeding), a pool of 4-8 platelet concentrates is usually sufficient to provide hemostasis in a thrombocytopenic, bleeding patient. 1
Equivalency with Apheresis Products
Random donor platelets can be used interchangeably with single-donor apheresis platelets, with one apheresis unit containing approximately 3-6 × 10^11 platelets (equivalent to 4-8 random donor units depending on local collection practices). 1, 2
The efficacy of random donor platelet concentrates and single-donor apheresis platelets is equivalent when stored for 5 days. 2
Important Caveats
Transfusion rate may need to be slowed in patients with cardiac compromise or volume overload concerns, though the evidence does not specify exact rates for these situations. 1
Leukoreduced blood products should be used to reduce alloimmunization, febrile reactions, and CMV transmission. 1, 2
The decision about transfusion rate should consider the clinical urgency—patients with active major bleeding may require more rapid infusion compared to prophylactic transfusions. 1