Indications for Transfusion of Platelets

Platelet transfusion may be indicated to prevent hemorrhage in patients with thrombocytopenia or platelet function defects.

 

Indications for Transfusion of Platelets in Adults

Prophylactic transfusion indications Platelet count (× 103per uL)
Major surgery or invasive procedure, no active bleeding </= 50
Ocular surgery or neurosurgery, no active bleeding </= 100
Surgery with active bleeding

< 50 (usually)

> 100 (rarely)

Stable, nonbleeding < 10
Stable, nonbleeding, and body temperature > 100.4°F (38°C) or undergoing invasive procedure < 20

Indications for Transfusion of Platelets in Neonates

Platelet count (× 103 per uL) Indications
< 20 Always transfuse
20 to < 30 Consider transfusion; transfuse for clinical reasons (e.g., active bleeding, lumbar puncture)
30 to 50

Transfuse if any of the following indications exist:

First week of life with birth weight < 1,000 g (2 lb, 4 oz)

Intraventricular or intraparenchymal cerebral hemorrhage

Coagulation disorder

Sepsis or fluctuating arterial venous pressures

Invasive procedure

Alloimmune neonatal thrombocytopenia*

* Select a donor (possibly the mother) whose platelets lack the causative antigen. If the mother’s platelets are used, unit must be washed, irradiated, and resuspended in plasma that is ABO compatible with the neonate.

 

 

References:

  1. Liumbruno G, Bennardello F, Lattanzio A, Piccoli P, Rossetti G; Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) Work Group. Recommendations for the transfusion of plasma and platelets. Blood Transfus. 2009 Apr;7(2):132-50. [Medline]
  2. Poterjoy BS, Josephson CD. Platelets, frozen plasma, and cryoprecipitate: what is the clinical evidence for their use in the neonatal intensive care unit? Semin Perinatol. 2009;33(1):66–74. [Medline]
  3. Sharma S, Sharma P, Tyler LN. Transfusion of blood and blood products: indications and complications. Am Fam Physician. 2011 Mar 15;83(6):719-24. [Medline]

Created Jun 08, 2016.