Critera for Transfusion

[bldbnkr]

Hi,

Could anyone please share the most recent (2016?) AABB guidelines for transfusion of RC's, platelets and FP?  Or your own hospital's guidelines?

We have a new Medical Director and he quickly pointed out that our criteria are out of date, apparently the platelet level has dropped to 5 instead of 10?

Thank you!

[PammyDQ]

I am answering the moderator's call to answer lingering unanswered posts. So here I go...

Our thresholds vary by circumstance. We do marrow and stem cell transplants and have an active cancer center, therefore use a lot of platelets. Conservation is imperative so we strictly monitor their use.

For the autologous transplants, our criteria for prophylactic platelet transfusion is <5. For allogeneic it's <10. We also use the immature platelet fraction to determine whether the patient's marrow is recovering which might lead us to being more conservative if they're trending up. If they're febrile, septic, bleeding, having an invasive procedure, on certain anticoagulents then they may raise the threshold. Some non-BMT oncologists are more liberal with platelet transfusions for their outpatients, often using 20 as a minimum.

For the general patient population, we are also restrictive, but try keep transfusions below 10. But again, the overall picture will determine if we choose to question/restrict their order. 

For ITP, we suggest no platelet transfusion unless they're bleeding. They need to be treated with corticosteroids.

Our Medical Director publishes a pocket guide with many different aspects of transfusion medicine. Data is based on Circular of Information, standards, peer reviewed studies, AABB, FDA, etc. It's given to the house staff every year. It's very handy and we can remind the docs to check page so-and-so if they order something we question. 

[Cliff]

On 1/19/2021 at 11:29 AM, PammyDQ said:

I am answering the moderator's call to answer lingering unanswered posts.

and I thank you.