Global Journal of Transfusion Medicine

: 2019  |  Volume : 4  |  Issue : 2  |  Page : 140--147

Platelet refractoriness

B Sunil Rajadhyaksha, D Priti Desai, A Anisha Navkudkar 
 Department of Transfusion Medicine, Tata Memorial Hospital, HBNI, Mumbai, Maharashtra, India

Correspondence Address:
Dr. B Sunil Rajadhyaksha
Department of Transfusion Medicine, Tata Memorial Hospital, HBNI, Mumbai, Maharashtra

Platelet transfusion support is extensively required for hemato-oncology patients who are multiply transfused. Platelet refractoriness can represent a significant clinical condition that complicates the platelet transfusion support in such patients. It remains a challenge associated with an increased bleeding risk, longer hospital stays, and increased morbidity and mortality. Causes for refractoriness are broadly divided into nonimmune and immune causes. Approximately two-thirds of refractory episodes are due to nonimmune factors while one-third are due to immune factors. Common formulae to assess platelet refractoriness include corrected count increment (CCI), posttransfusion platelet increment, and percentage platelet recovery. Measurement of CCI is one of the best parameters to differentiate between immune and nonimmune causes. In nonimmune factors which are associated with increased platelet consumption, treating the underlying cause and increasing the frequency of transfusion should be considered. However, in immune factors which are due to increased destruction of platelets owing to alloimmunization, other strategies such as ABO-identical/ABO-compatible fresh platelets, human leukocyte antigen-matched platelets, and crossmatched platelet transfusions should be considered. The newer approach includes epitope-matched platelet transfusion which is still in amateur stage. The strategies in the prevention of alloimmunization include leukoreduction of blood components, reducing donor exposure by providing single-donor platelets, and providing ABO-compatible platelets from the beginning of the treatment. This review will address the causes of platelet refractoriness and practical approach to the diagnosis, management, and its prevention.

How to cite this article:
Rajadhyaksha B S, Desai D P, Navkudkar A A. Platelet refractoriness.Glob J Transfus Med 2019;4:140-147

How to cite this URL:
Rajadhyaksha B S, Desai D P, Navkudkar A A. Platelet refractoriness. Glob J Transfus Med [serial online] 2019 [cited 2023 Feb 4 ];4:140-147
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