Criteria:
(1) at least 3 platelet transfusions (not necessarily consecutive) within a 2 week period result in
(2) an inadequate post-transfusion platelet count increment.
where:
• Petz (2000) cites Koerner et al (1988) relative to using 3 transfusions for defining a refractory response. Koerner refers to 3 consecutive platelet transfusion, while Petz uses 3 platelet transfusions in a 2 week period, not necessarily consecutive.
Measures of post-transfusion platelet count increment:
(1) percentage platelet recovery (PPR)
(2) corrected count increment (CCI): reported in platelets per 10^ platelets transfused per meter square BSA
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Criteria for Inadequate Increase in the Post-Transfusion Platelet Count
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Specimen
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Using the PPR
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Using CCI
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at 1 hour
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< 30%
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< 7,500
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at 20 hours
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< 20%
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< 5,000
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In the ASCO clinical practice guidelines for platelet transfusions (Schiffer et al), the platelet products should be:
(1) ABO compatible
(2) stored less than 72 hours
before the patient is considered refractory. However, I am not sure if I have ever encountered platelets being transfused that were > 72 hours old.
