O'Brien Kerry, Bakhtary Sara, Benson Kaaron, Stephens Laura, Lu Wen
Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.
Am J Clin Pathol. 2022 Dec 1;158(6):687-691. doi: 10.1093/ajcp/aqac102.
Platelets are a limited resource frequently subject to inventory shortages. It benefits all to transfuse judiciously, according to evidence-based guidelines. Several organizations have published recommendations for platelet transfusions, but none specifically focused on outpatients. The Clinical Hemotherapy subsection of the Association for the Advancement of Blood & Biotherapies (AABB) Transfusion Medicine Subsection Coordinating Committee conducted a survey targeting outpatient transfusions to understand current practice in the United States.
To determine use of platelets in the outpatient setting, a survey was developed, piloted, validated, and distributed by email to 735 AABB members. Frequencies were calculated and free-text comments categorized.
A total of 317 responses were received (43% response rate) from 44 states. Half the respondents' institutions have formal outpatient platelet guidelines. Slightly more than half the respondents (51%) with guidelines used a threshold of less than 10,000/µL when transfusing stable, afebrile outpatients, with 29% using less than 20,000/µL. Fewer than half (45%) monitored outpatient platelet use by prospective and retrospective audits, with the next-largest group (25%) using retrospective audits only.
Approximately half the respondents had outpatient guidelines, and half used a threshold of less than 10,000/µL when transfusing platelets to stable outpatients. Greater adoption of this threshold and monitoring may improve the nation's platelet inventory.
