"Trial" platelet transfusions

[janet]

I'm curious what others out there think of this:

We have a hematologist/oncologist who has given "trial" platelet transfusions (two separate occasions to two seperate patients with ?ITP "to see if they will respond if platelets were needed during a planned surgery"). Both patients had platelet counts in the 80's but the surgeons did not want to perform the procedure before consulting a hematologist. I questioned him before the first "trial" happened and he was quite irrate to be questioned. Needless to say I just gave out the second "trial" set since my lab director didn't really back me in the first case. Platelet counts did not go up in the first case (actually dropped to 60 after 5 days). The second case did not show a response in the first day....see what happens to her counts the next few days!

Any thoughts for or against this physicians' practice?

[lef5501]

Wow, this seems like a waste of a product that is really hard to come by. If my docs started doing this practice, I would really have to question them about it. Since they are doing this to see if the pt responds to plts in case of need during surgery, does it mean they won't do surgery if the pt didn't respond to the "trial" transfusion? If they are still going to do the surgery no matter what, why bother with the "trial" run.

[caj1018]

It seems to me that your docs have used flawed logic: "If the patient's have never been transfused with platelets before, then lets give them some even though they currently don't need them so that they can be sensitized to platelet antigens thereby decreasing the odds that platelet transfusions will be beneficial in the future."

Sounds like you work at a teaching hospital. I thnk our patients have a right NOT to be experimented on!

[jhaig]

Patients are not guinea pigs to be experimented upon. Why would a physician knowingly expose a patient to possible transfusion risk (virus transmission, bacteriologic infection, etc) just to see what happens? And while we're at it, let's give the patient an opportunity to make platelet antibodies so future transfusions may not work?! I'm surprised your pathologist agreed to this. I don't know what your chain of command is, but this could also be a risk management issue.