Hi all,

Does anyone have a policy specifically regarding Plavix and platelet transfusion?

For elective surgery that patient should be off Plavix for at least 7 days but what about GI bleeds or emergency surgery?

Some doctors seem to feel that one unit of pheresis platelet will adsorb out the plavix in the patients circulation and still leave some fresh platelets while others and some literature seem to indicate more than one unit should be given.

Thoughts?

I do not know of any hospital policy but we do not have any policy in the blood bank. But I know that one of our patient started bleeding and anesthesia wanted four singel donor plateletpheresis. When I called him(3 am) to confirm the order he told me that he will use all and indeed he used them all.

As far as I know they do not do schedule surgery, I know the patient I mentioned above went for emergency surgery.

We have issues with this a lot with our heart patients that need rushed to open heart surgery. To my knowledge there is no written procedure, it is up to the physician's discretion as to how many pheresis he thinks is necessary. But it generally ranges from 1-3. As for general, scheduled surgery, they seem to try to keep the patient off plavix prior to the surgery.

Our Plavix patients are typically transfused with 2-3 apheresis units before the CV surgeons are satisfied. One apheresis unit doesn't seem to do the job.

BC