Evaluation of Platelet Transfusions Practice: Results of at a Tertiary Healthcare Center in Turkey

Öz

Background: Platelet transfusion is an effective method used to prevent and treat bleeding in thrombocyto-penic patients. The impact of platelet transfusion without respecting the ABO compatibility on platelet transfusion refractoriness is debated. We aimed to evaluate platelet transfusions practice at our tertiary care hospital.
Materials and Methods: We analyzed 849 hematology-oncology patients who underwent platelet transfu-sion at Dokuz Eylül University Hospital between January 2014 and December 2020. Case under the age of 18 were excluded from the study. We retrospectively assessed the demographic data of selected cases, the types of transfusion products employed, and patients’ laboratory parameters.
Results: Hematology-oncology patients accounted for 44.6% (n=849) of the transfusions. Much of the remainder is used in the emergency department 11.7% (n=224) and intensive care 6.8% (n=131). Eight hundred and forty-nine hemato-oncological patients were retrospectively identified between 2014 and 2020. The median age was 60 (18–91) years, with 44.6% women. ABO-identical platelet transfusions were 93.6%. Eighty-one percent of platelets were transfused to patients with counts < 25 × 10^6 µL. Post transfu-sion the next day, platelet count increment <10 × 10^6 µL was 31.6%, 37.5%, 30.0% for ABO compatible, ABO major incompatible, and ABO minor incompatible, respectively.
Conclusions: We conclude that platelet transfusions should always be made to only ABO identical platelets whenever possible. As with every blood product transfusion, comprehensive and practical national policies should be developed based on international guidelines for causing minimum side effects and maximum efficacy for platelet transfusion.

Anahtar Kelimeler

• Platelet transfusion
• ABO blood group
• Refractoriness
• ABO compatibility
• Platelet transfusion, ABO blood group, Refractoriness, ABO compatibility

Trombosit Transfüzyonu Uygulamasının Değerlendirilmesi: Türkiye'de Üçüncü Basamak Sağlık Merkezi Sonuçları

Öz

Amaç: Trombosit transfüzyonu trombositopenik hastalarda kanamayı önlemek ve tedavi etmek için standart ve etkili bir tedavidir. ABO uyumluluğu gözetilmeksizin trombosit transfüzyonunun trombosit transfüzyon refrakterliği üzerindeki etkisi tartışılmalıdır. Üçüncü basamak hastanemizde ABO ile uyumlu olan veya olmayan trombosit transfüzyonu uygulamamızı değerlendirmeyi amaçladık. Gereç ve Yöntem: Türkiye'deki 9 Eylül Üniversite Hastanesinde Ocak 2014'ten Aralık 2020'ye kadar 849 trombosit transfüze hematoloji-onkoloji hastasını analiz ettik. 18 yaş altı olgular çalışma dışı bırakıldı. Seçilmiş vakaların demografik verilerini, kullanılan transfüzyon ürünlerinin uygunlukları ve hastaların laboratuvar parametrelerini geriye dönük olarak değerlendirdik. Bulgular: Transfüzyon yapılan hastaların %44,6'sını hematoloji-onkoloji hastaları oluşturdu. Transfüzyon uygulamalarının %11’i acil serviste ve %6.8’sı yoğun bakım ünitelerinde uygulandı. 2014 ve 2020 yılları arasında sekiz yüz kırk dokuz hemato-onkolojik hasta geriye dönük olarak tanımlandı. Ortanca yaş 60 (18–91) idi ve %44.6'sı kadındı. ABO-tam uyumlu trombosit transfüzyonları %93,6 idi. Trombositlerin yüzde seksen biri, sayısı < 25 × 10^6 µL olan hastalara transfüze edildi. Transfüzyondan bir sonraki gün, trombosit sayısı artışı <10 × 10^6 µL, sırasıyla ABO uyumlu, ABO majör uyumsuz ve ABO minör uyumsuz için sırasıyla %31.6, %37.5, %30.0 idi. Sonuç: Trombosit transfüzyonlarının mümkün olduğunda her zaman sadece ABO ile özdeş trombositlere yapılması gerektiği sonucuna vardık. Her kan ürünü transfüzyonunda olduğu gibi, trombosit transfüzyonunda da minimum yan etki ve maksimum etkinliğe neden olmak için uluslararası kılavuzlara dayalı kapsamlı ve pratik ulusal politikalar geliştirilmelidir. Anahtar Kelimeler: Trombosit transfüzyonu, ABO kan grubu, refrakterlik, ABO uyumluluğu

Anahtar Kelimeler

• Platelet transfusion
• ABO blood group
• refractoriness
• ABO compatibility
• Platelet transfusion, ABO blood group, refractoriness, ABO compatibility

Kaynakça

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