-
Transfusion Oct 2020
Topics: Humans; Myelodysplastic Syndromes; Platelet Transfusion; Thrombocytopenia
PubMed: 33615501
DOI: 10.1111/trf.16093 -
Blood Dec 2023
Topics: Deep Learning; Platelet Transfusion
PubMed: 38153770
DOI: 10.1182/blood.2023022981 -
Transfusion Mar 2023
Topics: Humans; Swimming; Platelet Transfusion; Platelet Count
PubMed: 36494900
DOI: 10.1111/trf.17207 -
Platelets Jan 2022The supply of platelets for transfusion is a logistical challenge due to the physiology of platelets and current measures of transfusion performance dictating storage at... (Review)
Review
The supply of platelets for transfusion is a logistical challenge due to the physiology of platelets and current measures of transfusion performance dictating storage at 22°C and a short product shelf-life (<7 days). Demand for platelets has increased in recent years and changes in the demographics of the population may enhance this further. Many studies have been conducted to understand what the optimal dose and trigger for transfusion should be, mainly in hematology patients who are the largest cohort that receive platelets, mostly to prevent bleeding. Emerging data suggests that for bleeding patients, where immediate hemostasis is a key consideration, the current standard product may not be optimal. Alternative platelet preparation methods/storage options that may improve the hemostatic properties of platelets are under active development. In parallel with research into alternative platelet products that might enhance hemostasis, better measures for assessing bleeding risk and platelet efficacy are needed.
Topics: Blood Platelets; Humans; Platelet Transfusion
PubMed: 34392769
DOI: 10.1080/09537104.2021.1961711 -
Arteriosclerosis, Thrombosis, and... Jun 2023
Topics: Infant, Newborn; Humans; Platelet Transfusion; Hemostasis; Thrombocytopenia
PubMed: 37139838
DOI: 10.1161/ATVBAHA.123.319252 -
Scientific Reports Feb 2021Despite encouraging results reported with regards to Platelet-rich plasma (PRP) application in osteoarthritis (OA) knee, still critical issues like conclusive structural... (Clinical Trial)
Clinical Trial
Despite encouraging results reported with regards to Platelet-rich plasma (PRP) application in osteoarthritis (OA) knee, still critical issues like conclusive structural evidence of its efficacy, standard dose and good manual method of preparation to obtain high yield remains unanswered. Present study is an attempt to optimise the dose and concentration of therapeutic PRP and its correlation with structural, physiologic efficacy with a new manual method of PRP preparation. A total of one hundred and fifty patients were randomized to receive either PRP (10 billion platelets) or hyaluronic acid (HA; 4 ml; 75 patients in each group) and followed up till 1 year. An addition of filtration step with 1 µm filter in manual PRP processing improved platelet recovery upto 90%. Significant improvements in WOMAC (51.94 ± 7.35 vs. 57.33 ± 8.92; P < 0.001), IKDC scores (62.8 ± 6.24 vs 52.7 ± 6.39; P < 0.001), 6-min pain free walking distance (+ 120 vs. + 4; P < 0.001) persisted in PRP compared to HA group at 1 year. Significant decline IL-6 and TNF-α levels observed in PRP group (P < 0.05) compared to HA at 1 month. Study demonstrated that an absolute count of 10 billion platelets is crucial in a PRP formulation to have long sustained chondroprotective effect upto one year in moderate knee OA.
Topics: Aged; Dose-Response Relationship, Drug; Humans; Hyaluronic Acid; Injections, Intra-Articular; Knee Joint; Male; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Platelet Transfusion; Platelet-Rich Plasma; Random Allocation; Treatment Outcome
PubMed: 33597586
DOI: 10.1038/s41598-021-83025-2 -
Hamostaseologie Apr 2021Aside from their canonical role in hemostasis, it is increasingly recognized that platelets have inflammatory functions and can regulate both adaptive and innate immune... (Review)
Review
Aside from their canonical role in hemostasis, it is increasingly recognized that platelets have inflammatory functions and can regulate both adaptive and innate immune responses. The main topic this review aims to cover is the proinflammatory effects and side effects of platelet transfusion. Platelets prepared for transfusion are subject to stress injury upon collection, preparation, and storage. With these types of stress, they undergo morphologic, metabolic, and functional modulations which are likely to induce platelet activation and the release of biological response modifiers (BRMs). As a consequence, platelet concentrates (PCs) accumulate BRMs during processing and storage, and these BRMs are ultimately transfused alongside platelets. It has been shown that BRMs present in PCs can induce immune responses and posttransfusion reactions in the transfusion recipient. Several recent reports within the transfusion literature have investigated the concept of platelets as immune cells. Nevertheless, current and future investigations will face the challenge of encompassing the immunological role of platelets in the scope of transfusion.
Topics: Humans; Platelet Count; Platelet Transfusion
PubMed: 33711849
DOI: 10.1055/a-1347-6551 -
Transfusion Jun 2021Platelet transfusion refractoriness (PTR), defined as an unsatisfactory post-transfusion platelet count increment, is a common complication of patients receiving...
Platelet transfusion refractoriness (PTR), defined as an unsatisfactory post-transfusion platelet count increment, is a common complication of patients receiving multiple transfusions. Different strategies are described in the management of PTR. In this work, we demonstrate the efficacy of the detection and identification of anti-HLA antibodies in the recipient using a threshold of 3000 mean fluorescence intensity (MFI), and the seek of donors not expressing HLA antigens against which the patient is immunized.
Topics: Adult; Aged; Blood Platelets; Female; HLA Antigens; Humans; Immunization; Isoantibodies; Male; Middle Aged; Platelet Count; Platelet Transfusion; Retrospective Studies; Young Adult
PubMed: 33709433
DOI: 10.1111/trf.16358 -
Transfusion Medicine Reviews Jul 2021Preterm neonates with severe thrombocytopenia are frequently prescribed prophylactic platelet transfusions despite no evidence of benefit. Neonatal platelet transfusion... (Review)
Review
Preterm neonates with severe thrombocytopenia are frequently prescribed prophylactic platelet transfusions despite no evidence of benefit. Neonatal platelet transfusion practice varies, both nationally and internationally. Volumes and rates of transfusion in neonatology are based on historic precedent and lack an evidence base. The etiology of harm from platelet transfusions is poorly understood. Neonates are expected to be the longest surviving recipients of blood produce transfusions, and so avoiding transfusion associated harm is critical in this cohort. This article reviews the evidence for and against platelet transfusion in the neonate and identifies areas of future potential neonatal platelet transfusion research.
Topics: Blood Transfusion; Humans; Infant, Newborn; Platelet Transfusion; Thrombocytopenia
PubMed: 34312045
DOI: 10.1016/j.tmrv.2021.06.003 -
Platelets Jan 2022The neonatal hemostatic system is different from that of adults. The differences in levels of procoagulant and anticoagulant factors and the evolving equilibrium in... (Review)
Review
The neonatal hemostatic system is different from that of adults. The differences in levels of procoagulant and anticoagulant factors and the evolving equilibrium in secondary hemostasis during the transition from fetal/neonatal life to infancy, childhood, and adult life are known as "developmental hemostasis." In regard to primary hemostasis, while the number (150,000-450,000/µl) and structure of platelets in healthy neonates closely resemble those of adults, there are significant functional differences between neonatal and adult platelets. Specifically, platelets derived from both cord blood and neonatal peripheral blood are less reactive than adult platelets to agonists, such as adenosine diphosphate (ADP), epinephrine, collagen, thrombin, and thromboxane (TXA) analogs. This platelet hyporeactivity is due to differences in expression levels of key surface receptors and/or in signaling pathways, and is more pronounced in preterm neonates. Despite these differences in platelet function, bleeding times and PFA-100 closure times (an test of whole-blood primary hemostasis) are shorter in healthy full-term infants than in adults, reflecting enhanced primary hemostasis. This paradoxical finding is explained by the presence of factors in neonatal blood that increase the platelet-vessel wall interaction, such as high von Willebrand factor (vWF) levels, predominance of ultralong vWF multimers, high hematocrit, and high red cell mean corpuscular volume. Thus, the hyporeactivity of neonatal platelets should not be viewed as a developmental deficiency, but rather as an integral part of a developmentally unique, but well balanced, primary hemostatic system. In clinical practice, due to the high incidence of bleeding (especially intraventricular hemorrhage, IVH) among preterm infants, neonatologists frequently transfuse platelets to non-bleeding neonates when platelet counts fall below an arbitrary limit, typically higher than that used in older children and adults. However, recent studies have shown that prophylactic platelet transfusions not only fail to decrease bleeding in preterm neonates, but are associated with increased neonatal morbidity and mortality. In this review, we will describe the developmental differences in platelet function and primary hemostasis between neonates and adults, and will analyze the implications of these differences to platelet transfusion decisions.
Topics: Blood Platelets; Humans; Platelet Transfusion
PubMed: 34392772
DOI: 10.1080/09537104.2021.1962837