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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 (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 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted August 7, 2003 Accepted July 21, 2004 Factors affecting post-transfusion 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 Puget Sound Blood Center, Seattle, WA, USA Statistics, University of Washington, Seattle, WA, USA University of Minnesota, Minneapolis, MN, USA John Hopkins University, Baltimore, MD, USA University of Florida, Gainesville, FL, USA University of Maryland Cancer Center, Baltimore, MD, USA Blood Center of Southeastern Wisconsin, Milwaukee, WI, USA Histocompatibility Laboratory, Emory University, Atlanta, GA, USA University of Wisconsin, Madison, WI, USA * Corresponding author; email: sjslichter{at}psbc.org. A variety of patient and product related factors influenced the outcome of 6,379 transfu-sions given to 533 patients in the Trial to Reduce Alloimmunization to Platelets (TRAP Trial).(1) 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, 2 prior pregnancies, male gender, splenomegaly, bleeding, fever, infection, DIC, increasing height and weight, lymphocytotoxic antibody positivity, an increasing number of platelet transfusions or receiving heparin or amphotericin were associated with decreased post-transfusion platelet responses. Platelet factors that were associated with improved platelet responses were giving ABO-compatible platelets, platelets stored for 48 hours, and giving large doses of platelets while 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 main-tained while all other products showed substantial reductions. Refractoriness to platelet transfusions developed in 27% of the patients. Platelet refracto-riness was associated with lymphocytotoxic antibody positivity, heparin administration, fever, bleeding, increasing number of platelet transfusions, increasing weight, 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: S. D. O'Connor, A. J. Taylor, E. C. Williams, and T. C. Winter Coagulation Concepts Update Am. J. Roentgenol., December 1, 2009; 193(6): 1656 - 1664. [Abstract] [Full Text] [PDF] 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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