time interval for transfusing plts prior to surgery

[vhughes1116]

trying to find standard of practice for how long prior to scheduled surgery are platelets transfused if indicated. thanks

Virginia Hughes

Somers Point, NJ

[Malcolm Needs ☆]

trying to find standard of practice for how long prior to scheduled surgery are platelets transfused if indicated. thanks

Virginia Hughes

Somers Point, NJ

To be perfectly honest with you, being a pure (well, a bit naughty, but mostly pure) red cell immunohaematologist, I'm not sure about this myself, but in all the books I've read on the subject, the highest platelet count post-transfusion is after 1 hour, because before this the platelets are sequestered in the liver (small amount) and spleen (large amount). I suppose one could extrapolate, therefore, that this is the time when the maximum number of platelets are available for doing what platelets do best; but I am guessing.

:confused:

[David Saikin]

It depends why they need to be transfused . . . bleeding, plt disorder, coag disorder, low count . . . I don't have an answer.

[Brenda K Hutson]

I am not a Hematologist, but I too vote for 1 hour for the following reason. When working at one Institution that transfuses so many platelets that they actually have 1 FTE called a Platelet Coordinator, they would request that a 1 hour post count be done to see whether they had a good response or not (and they would use some calculation then to determine how successful those particular platelets were for that patient; i.e. patients who are refractory to patients).

Brenda Hutson, CLS(ASCP)SBB

[Lcsmrz]

Assuming the platelets will survive normally and you're transfusing them for an incidental low count (<100?), anytime the day of surgery should be fine.

If the patient is actively destroying them or is refractory, I like the one hour limit.

If it's a patient undergoing splenectomy, I wonder if it's necessary, since the count should rebound post-Op.