Platelet transfusion for patients with platelet dysfunction: effectiveness, mechanisms, and unanswered questions.
Curr Opin Hematol
; 27(6): 378-385, 2020 11.
Article
en En
| MEDLINE
| ID: mdl-32868672
ABSTRACT
PURPOSE OF REVIEW In this review, we discuss current clinical guidelines and potential underlying mechanisms regarding platelet transfusion therapy in patients at risk of bleeding, comparing management of patients with thrombocytopenia versus those with qualitative platelet disorders. RECENT FINDINGS:
Platelet transfusion therapy is highly effective in managing bleeding in patients with hypoproliferative thrombocytopenia. Clinical trials have demonstrated that platelet transfusion can be used at a lower trigger threshold and reduced platelet doses, and may be used therapeutically rather than prophylactically in some situations, although additional data are needed. In patients with inherited platelet disorders such as Glanzmann's Thrombasthenia or those with RASGRP2 mutations, platelet transfusion may be ineffective because of competition between transfused and endogenous platelets at the site of vascular injury. Successful management of these patients may require transfusion of additional platelet units, or mechanism-driven combination therapy with other pro-hemostatic agents. In patients on antiplatelet therapy, timing of transfusion and inhibitor mechanism-of-action are key in determining therapeutic success.SUMMARY:
Expanding our understanding of the mechanisms by which transfused platelets exert their pro-hemostatic function in various bleeding disorders will improve the appropriate use of platelet transfusion.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Trastornos de las Plaquetas Sanguíneas
/
Transfusión de Plaquetas
Tipo de estudio:
Guideline
/
Qualitative_research
Límite:
Animals
/
Humans
Idioma:
En
Revista:
Curr Opin Hematol
Asunto de la revista:
HEMATOLOGIA
Año:
2020
Tipo del documento:
Article