Protocols - Hemorio

PLATELET TRANSFUSIONAL YIELD:
Key:
CPPOS – Post-transfusion platelets counting
CPPRE – Pre-transfusion platelets counting
PLTR – Total transfused platelets
VP – Product volume (ml)
(CPPOS – CPRE) X WEIGHT (KG) X 0.075 X 10 6
PLTR X VP X 10 3
HANDLING OF REFRACTORY SUBJECTS:
In refractory subjects, the general recommendation is not to transfuse prophylactically, unless you have
HLA-compatible platelets.
The pre- and post-transfusional platelets counting is recommended in subjects who receive iterative
transfusions. The post-transfusional counting can be done after elapsing 10 minutes to 1 hour from the
end of transfusion. The optimal situation is to perform the 1- counting between 15 minutes to 1 hour, and
after 24 hours after the transfusion is performed.
The post-transfusional platelets counting must be mandatory done in the subjects who present, during or
right after the transfusion, a febrile reaction with or without chills, chills with no fever or sensation of
imminent death. Once the refractivity is confirmed, the subjects must be transfused using the following
strategies:
SUBJECTS TO WHOM IT IS NOT POSSIBLE TO OBTAIN HLA-COMPATIBLE PLATELETS
ABO-compatible platelets.
Platelets collected for less than 48 hours.
In subjects who are concurrently receiving Amphotericin B, make an interval of 2 hours between the
infusion of antibiotic and the transfusion, and vice-versa.
If, in spite of those measures, the transfusions are still inefficient, interrupt the prophylactic transfusions
and transfuse the subjects only in cases of hemorrhages or before any symptom or sign suggesting
intracerebral hemorrhage (therapeutic transfusions).
In such cases, the curative transfusions must be done every 8 to 12 hours, until the hemorrhage is
controlled.
SUBJECTS TO WHOM IT IS POSSIBLE TO OBTAIN HLA-COMPATIBLE PLATELETS:
The compatibility may be performed through a cross match or through the selection of donors with HLA
phenotype compatible to the subject, or compatible to the antibody(s) that he presents.
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