Patient selection: pediatric patient with thrombocytopenia
Complications of platelet transfusion include:
(1) transfusion reaction
(2) alloimmunization with risk of future refractoriness to platelet transfusion
(3) infection from contaminated product
Indications for platelet transfusion - one of the following:
(1) platelet count <= 10,000 per µL
(2) platelet count > 10,000 per µL with one of the following:
(2a) symptomatic (bleeding)
(2b) undergoing an invasive procedure AND moderate/severe thrombocytopenia
(2c) other significant risk factor for bleeding
Issues in implementation:
(1) Qualitative platelet defects are not specifically addressed.
(2) While thrombocytopenia is < 150,000 per µL, the risk of bleeding varies over the range from 10,000 to 150,000. Platelet count alone may not predict the risk of bleeding.
