Fresh out of school blood banker here, so please bare with me if I am not getting the technical terms correctly

Does the platelet refractoriness to transfusion refer to as poor recovery or shortern survival of transfused platelet? I wonder what are the chance of refractoriness due to alloimmunity(Anti-HLA etc)?

If I see a patient who has been transfused over and over again with shortern platelet life (i think, after 2-3 day she is back to her low 5-10) should i be bringing it to pathologist's attention? ?

Your definition and likely cause of platelet refractoriness is correct.

I think that we (in the Blood Bank) are often not in a good place to judge whether the patient has been refractory to platelet transfusions, because we often don't have information about the patient's diagnosis, whether they are actively bleeding somewhere, or whether the pt has a fever, etc. (All of these things can affect the success of platelet transfusions.) The physician should be in a better position to determine if a patient has become refractory.

Getting a decent rise in the post-transfusion platelet count, then seeing the platelet count drop back down after 2 or 3 days is pretty normal in our experience, and probably does not mean that the patient is refractory. It seems like our refractory patients hardly get a bump in their platelet count at all after they receive a platelet transfusion.

Back to your last question: Of course it's a good idea to bring a patient to your pathologist's attention if the patient doesn't seem to be benefitting from platelet transfusions. (Is your pathologist prepared to offer suggestions on how to better manage this patient's platelet needs?)

Donna

Do a plt ct an hour after infusion . . . if there is no increment the pt is probably refractory. If there is then the plts are just being used naturally.

If you go into Library at the top of the page, followed by educational material, you will find a Powerpoint lecture (and an accompanying Word document) named HLA in transfusion and transplantation (or words to that effect) that we give you a step by step account of platelet refractoriness.

thanks!