Clinical Significance

The therapeutic goal of platelet transfusion is to provide adequate numbers of normally functioning plateltets for the prevention or cessation of bleeding and maintenance of hemostasis. In an average size adult, platelet counts for each plateletpheresis bag should result in a 10,000 - 60,000 /uL increase. In neonates and infants, a dose of 5-10 mL/kg of platelets should result in a 50,000 - 100,000 /uL increment increase. If platelet function is normal, platelets should not be transfused if the platelet count is greater than 100,000 /uL.

Platelets may be useful if given prophylactically to patients with rapidly decreasing or low platelet counts (usually less than 10,000/uL secondary to cancer, marrow aplasia, or chemotherapy. Platelet transfusion may also be useful in selected cases of postoperative bleeding, e.g. platelet counts less than 50,000 /uL.

Platelet transfusions are not usually effective or indicated in patients with destruction of circulating platelets due to autoimmune disorders such as immune thrombocytopenic purpura (ITP) or thrombotic thrombocytopenic purpura (TPP), unless the patient has a life-threatening hemorrhage.