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Platelet Transfusion; What and When to Transfuse, a Dilemma of Clinical Practice

Tasnim Ahsan, Rukhshanda Jabeen, Urooj Lal Rehman, Zeenat Banu and Samar Abbas Jaffri

Objective: To evaluate the effectiveness of guidelines driven platelet transfusion as well as to compare effectiveness of low verses high dose of the platelets transfusion.

Study design: Observational chart analysis study.

Place and duration of study: Jinnah Post Graduate Medical Center, Medical unit II, for 2 years in 2011 (Study- A) and 2012 (Study-B).

Material and method: Study A included 130 and Study B included 111 patients. In Study-A, retrospective chart analysis was done for all the patients who were either bleeding or had low platelet counts. Platelet transfusions given to these patients were evaluated. Based on these results and WHO bleeding stages; guidelines were structured for futures platelet transfusion. In Study B platelet transfusion were driven by these guidelines. Outcomes in form of discharge and death of patients given low, medium and high dose platelets were compared.

Results: In Study A; 98 patients were transfused platelets, out of which only 76 were actively bleeding; while in Study B platelets were transfused in 65 patients of whom 62 patients were having active bleeding. The outcome in term of patient discharged and expired was seen to be comparable in different dosage groups with a significant P value <0.005.

Conclusion: After following guidelines, 1% inappropriate platelet transfusions were administered as compared to 20% inappropriate transfusions in previous year. Low dose platelets were as effective as high dose platelets.