Slichter Sherrill J
Puget Sound Blood Center, 921 Terry Avenue, Seattle, WA 98104-1256, USA.
Hematol Oncol Clin North Am. 2007 Aug;21(4):697-729, vii. doi: 10.1016/j.hoc.2007.06.010.
This article provides guidelines for the appropriate use of platelet transfusions to reduce unnecessary transfusions, thereby avoiding transfusion-related risks to the patients and the costs of platelet therapy. Platelet products available for transfusion are whole blood derived platelet concentrates and apheresis platelets. Leukoreduced platelets can be used to reduce platelet alloimmunization, cytomegalovirus transmission, and febrile transfusion reactions, while gamma irradiation prevents transfusion-associated graftversus-host disease. Other topics discussed are the expected response to transfused platelets and reasons for poor responses related to alloimmunization, underlying disease state, clinical conditions, and drugs. Appropriate transfusion guidelines based on pretransfusion platelet count, platelet dose, and whether the transfusion is prophylactic or therapeutic are outlined. Identification, prevention, and management of adverse consequences of platelet transfusions and platelet refractoriness are discussed.
本文提供了关于合理使用血小板输注的指导原则，以减少不必要的输注，从而避免给患者带来与输血相关的风险以及血小板治疗的费用。可供输注的血小板制品有全血来源的血小板浓缩物和单采血小板。白细胞滤除血小板可用于减少血小板同种免疫、巨细胞病毒传播和发热性输血反应，而γ射线照射可预防输血相关移植物抗宿主病。讨论的其他主题包括输注血小板的预期反应以及与同种免疫、基础疾病状态、临床情况和药物相关的反应不佳的原因。概述了基于输血前血小板计数、血小板剂量以及输血是预防性还是治疗性的适当输血指导原则。还讨论了血小板输注不良反应和血小板输注无效的识别、预防及管理。
