Hux Bryan D, Martin Linda G
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA.
J Vet Emerg Crit Care (San Antonio). 2012 Feb;22(1):73-80. doi: 10.1111/j.1476-4431.2011.00706.x.
To review current human and veterinary protocols for platelet transfusion triggers, available platelet transfusion products to support veterinary thrombocytopenic patients, and the advantages and disadvantages of each product.
Data from human and veterinary literature.
Prophylactic and therapeutic platelet transfusions are instrumental in managing human patients with thrombocytopenia. The platelet transfusion products used in human medicine consist of platelet concentrates, derived from pooled random donor platelets, or single-donor apheresis platelets. Historically, platelet transfusions in human medicine have been prophylactic in nature; however, recent research suggests changing from a prophylactic transfusion strategy to a therapeutic transfusion strategy may be safe for most patients. The optimal platelet transfusion trigger and the use of prophylactic verses therapeutic platelet transfusions are ever changing in human medicine.
There have been many advances in platelet transfusion products, but fresh whole blood remains the most commonly used platelet transfusion product in veterinary medicine. New products such as lyophilized platelets and cryopreserved platelets offer the benefits of long shelf life, immediate availability, and higher concentration of platelets at smaller doses. Veterinary platelet transfusion guidelines are mostly extrapolated from human literature because data on veterinary platelet transfusions are lacking.
In veterinary medicine the most commonly available product for platelet transfusions is fresh whole blood, because of availability of blood donors and lack of a cost effective easily obtainable alternative. Cryopreserved and lyophilized platelets are promising new products being used in the treatment of hemorrhaging patients with thrombocytopenia. These products offer increased platelet concentrations at decreased volumes, longer storage shelf life, and decreased exposure to whole blood products. With the development of newer readily available products, platelet transfusion parameters, to include dose, platelet count trigger, presence of disease, and clinical signs, should be further evaluated in veterinary medicine.
回顾当前人类和兽医领域关于血小板输注触发标准的方案、用于支持兽医血小板减少症患者的现有血小板输注产品，以及每种产品的优缺点。
人类和兽医文献数据。
预防性和治疗性血小板输注在治疗人类血小板减少症患者中发挥着重要作用。人类医学中使用的血小板输注产品包括由混合随机供体血小板或单采血小板制成的血小板浓缩物。从历史上看，人类医学中的血小板输注本质上是预防性的；然而，最近的研究表明，对于大多数患者来说，从预防性输血策略转变为治疗性输血策略可能是安全的。在人类医学中，最佳血小板输注触发标准以及预防性与治疗性血小板输注的使用一直在不断变化。
血小板输注产品有了许多进展，但新鲜全血仍然是兽医学中最常用的血小板输注产品。冻干血小板和冷冻保存血小板等新产品具有保质期长、可立即使用以及小剂量时血小板浓度更高的优点。兽医血小板输注指南大多是从人类文献中推断出来的，因为缺乏关于兽医血小板输注的数据。
在兽医学中，由于有献血者且缺乏经济高效、易于获得的替代产品，最常用的血小板输注产品是新鲜全血。冷冻保存和冻干血小板是用于治疗血小板减少性出血患者的有前景的新产品。这些产品在减少体积的情况下提高了血小板浓度，延长了储存保质期，并减少了对全血产品的接触。随着更新的易于获得的产品的开发，兽医学中应进一步评估血小板输注参数，包括剂量、血小板计数触发标准、疾病存在情况和临床体征。
