Protocols - Hemorio

Each dose corresponds to a unit of CP obtained from a unit of whole blood / 10 kg of weight from the
receptor or a unit of CP obtained by apheresis.
DOSES AND ADMINISTRATION INTERVALS
Prophylactic Transfusion: The dosage used must be 1 unit (or 5.5 X 10 10 platelets) for every 7-10 Kg of
subject’s weight. In children with a weight below 7 Kg, the dosage must be 10 to 15 ml/Kg. However,
lowest doses, of at least a unit for every 5 Kg of the subject’s weight, can be accepted. Most of the times,
the prophylactic transfusion needs to be repeated every 24 to 48 hours.
Therapeutic Transfusion: The purpose of the therapeutic transfusion of platelets is not to increase the
platelets counting above certain limit, but to help correcting the hemostatic disturbance, that might be
contributing to the hemorrhage.
The dosage at the curative transfusion is 1 unit for every 7 kg of weight, and the intervals of administration
are shorter (8 to 12 hours), until the hemorrhage is controlled.
The therapeutic transfusion of platelets is indicated for the subject that presents platelet dysfunction and
life-threatening hemorrhage, regardless the platelets counting.
The therapeutic transfusion of platelets is also indicated for the subject that presents ongoing hemorrhage
and platelets counting below 50,000/µL.
ABO-COMPATIBILITY AND Rh:
ABO-incompatible platelets transfusions are not contraindicated, although the ideal is always the
ABO-compatible platelets transfusion. When the platelets concentrates are roughly contaminated by
red blood cells, no ABO-incompatible platelets must be transfused.
The negative Rh subjects must only receive negative Rh platelets. If it is not possible, and if positive Rh
platelets must be used in negative Rh subjects, it is recommended the usage of anti-D immunoglobulin up
to 72 hours, after the transfusion, in order to prevent the sensitivity of the subject. This recommendation
must be strictly followed in female children and child-bearing potential women.
If the subject needs to be transfused again, the infusion of anti-D must be repeated only when the residual
pre-transfusional anti-D research is negative.
DE-LEUKOCYTATION OF PLATELETS: All platelets transfusions must be done, whenever possible, with
de-leukocytated platelets.
THROMBOCYTOPENIA AND ANEMIA: It is recommended that the dosage of hemoglobin in subjects
with post-chemotherapy thrombocytopenia is kept above 8g%. This recommendation is also applied to the
subjects refractory to the platelets transfusion for which no HLA-compatible platelets can be provided.
APLASIA OF POST-QT AND/OR RXT MARROW (INCLUDING TMO), APLASTIC ANEMIA AND MDS:
The transfusion is indicated when there are hemorrhages other than petechia, ecchymosis and
gingivorrhage, and the platelets counting is below 50,000/µL. Among the hemorrhages that require the
curative transfusion, the hemorrhagic blisters are included.
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