Isolated platelet concentrate transfusion during surgery: a single-center observational cohort study
© 2019 AABB BACKGROUND: Surgical patients receive platelet concentrates (PCs) for a variety of indications. However, there is limited evidence for efficacy or dosing of PCs. STUDY DESIGN AND METHODS: We performed a retrospective cohort study of surgical patients receiving isolated PC transfusion at a single academic tertiary medical center during 1 year. The primary outcome was reoperation for a bleeding complication. Bleeding complication rates were compared in patients transfused for different indications, and multivariable logistic regression was performed to determine variables associated with bleeding complications. RESULTS: Approximately 1% of surgical patients (n = 205), including 7% of cardiac surgery patients, received an isolated PC transfusion. Cardiac surgery patients accounted for 47% of isolated PC transfusions, followed by neurosurgery (19%) and gastrointestinal surgery (13%). Most patients (81%) received a single apheresis unit of PC. Common indications were antiplatelet drugs (50%), thrombocytopenia (19%), congenital platelet disorders (2%), and both thrombocytopenia and antiplatelet drugs (12%). Bleeding complications occurred in 23% of patients, with the lowest bleeding complication rate observed in patients transfused for antiplatelet drugs (13%) and the highest rate in patients transfused for thrombocytopenia with or without antiplatelet drugs (40% and 38%, respectively). Bleeding complications were more common in noncardiac surgery but had no association with transfusion indication. CONCLUSION: Despite transfusion for conventionally accepted indications, patients who received an isolated PC transfusion experienced a high rate of bleeding complications, particularly noncardiac surgery patients. Further studies are needed to establish optimal dosing, timing, and indications for perioperative PC transfusion.
Anders, M., Rock, P., Cartron, A., Chow, J., Henderson, R., Martz, D., Tanaka, K., & Mazzeffi, M. (2019). Isolated platelet concentrate transfusion during surgery: a single-center observational cohort study. Transfusion, 59 (5). http://dx.doi.org/10.1111/trf.15156