Platelet transfusions are now widely used in a range of clinical settings, particularly in hypoproliferative thrombocytopenia due to haematologic malignancies or their treatment, and in critical bleeding due to trauma, major surgery and obstetric haemorrhage.
Platelet concentrates in Australia now all undergo pre-release leucocyte depletion and bacterial screening, with the intention of reducing febrile non-haemolytic transfusions (and possibly alloimmunisation), and sepsis from bacterial contamination, respectively. However, some immunological and other hazards still remain. The best way to minimise potential complications of platelet transfusions is to avoid unnecessary transfusions, by promoting evidence-based practice in line with national clinical practice guidelines.
In this session, we will review the evidence base for our current practice, particularly focusing on recent large international trials on the role of prophylactic platelet transfusions in haematology/oncology. Challenges in interpreting the evidence, including the difficulties of describing bleeding in patients who may require platelet transfusions, and major evidence gaps requiring further research, will be addressed.