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Blood, 15 May 2005, Vol. 105, No. 10, pp. 4106-4114. Prepublished online as a Blood First Edition Paper on February 3, 2005; DOI 10.1182/blood-2003-08-2724. This Article Full Text Full Text (PDF) All Versions of this Article: 2003-08-2724v1 105/10/4106    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Slichter, S. J. Articles by Woodson, R. Search for Related Content PubMed PubMed Citation Articles by Slichter, S. J. Articles by Woodson, R. Related Collections Hemostasis, Thrombosis, and Vascular Biology Transfusion Medicine Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSFUSION MEDICINE Factors affecting posttransfusion platelet increments, platelet refractoriness, and platelet transfusion intervals in thrombocytopenic patients Sherrill J. Slichter, Kathryn Davis, Helen Enright, Hayden Braine, Terry Gernsheimer, Kuo-Jang Kao, Thomas Kickler, Edward Lee, Janice McFarland, Jeffrey McCullough, Glenn Rodey, Charles A. Schiffer, and Robert Woodson From the Blood Center of Southeastern Wisconsin, Milwaukee, WI; Johns Hopkins University, Baltimore, MD; Puget Sound Blood Center, Seattle, WA; University of Florida, Gainesville, FL; University of Maryland Cancer Center, Baltimore, MD; University of Minnesota, Minneapolis, MN; University of Wisconsin, Madison, WI; Histocompatibility Laboratory, Emory University, Atlanta, GA; Platelet Immunology Laboratory, Blood Center of Southeastern Wisconsin, Milwaukee, WI; Quality Control Laboratory for Platelet and White Cell Counting, University of Florida, Gainesville, FL; Statistics, and the Epidemiology Research Corporation, University of Washington, Seattle, WA. A variety of patientand product-related factors influenced the outcome of 6379 transfusions given to 533 patients in the Trial to Reduce Alloimmunization to Platelets (TRAP). Responses measured were platelet increments, interval between platelet transfusions, and platelet refractoriness. Patient factors that improved platelet responses were splenectomy and increasing patient age. In contrast, at least 2 prior pregnancies, male gender, splenomegaly, bleeding, fever, infection, disseminated intravascular coagulation, increasing height and weight, lymphocytotoxic antibody positivity, an increasing number of platelet transfusions, or receiving heparin or amphotericin were associated with decreased posttransfusion platelet responses. Platelet factors that were associated with improved platelet responses were giving ABO-compatible platelets, platelets stored for 48 hours or less, and giving large doses of platelets while ultraviolet B (UV-B) or gamma irradiation decreased platelet responses. However, in alloimmunized lymphocytoxic antibody-positive patients, the immediate increment to UV-B-irradiated platelets was well maintained, whereas all other products showed substantial reductions. Refractoriness to platelet transfusions developed in 27% of the patients. Platelet refractoriness was associated with lymphocytotoxic antibody positivity, heparin administration, fever, bleeding, increasing number of platelet transfusions, increasing weight, at least 2 pregnancies, and male gender. The only factors that reduced platelet refractoriness rates were increasing the dose of platelets transfused or transfusing filtered apheresis platelets. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: C. E. Gruenwald, B. W. McCrindle, L. Crawford-Lean, H. Holtby, C. Parshuram, P. Massicotte, and G. Van Arsdell Reconstituted fresh whole blood improves clinical outcomes compared with stored component blood therapy for neonates undergoing cardiopulmonary bypass for cardiac surgery: a randomized controlled trial. J. Thorac. Cardiovasc. Surg., December 1, 2008; 136(6): 1442 - 1449. [Abstract] [Full Text] [PDF] K. Kaushansky Historical review: megakaryopoiesis and thrombopoiesis Blood, February 1, 2008; 111(3): 981 - 986. [Abstract] [Full Text] [PDF] S. J. Slichter Evidence-Based Platelet Transfusion Guidelines Hematology, January 1, 2007; 2007(1): 172 - 178. [Abstract] [Full Text] [PDF] J.-L. H. Kerkhoffs, J. C. Eikenboom, M. S. Schipperus, R. J. van Wordragen-Vlaswinkel, R. Brand, M. S. Harvey, R. R. de Vries, R. Barge, D. J. van Rhenen, and A. Brand A multicenter randomized study of the efficacy of transfusions with platelets stored in platelet additive solution II versus plasma Blood, November 1, 2006; 108(9): 3210 - 3215. [Abstract] [Full Text] [PDF]

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