Platelet function testing to assess effectiveness of platelet transfusion therapy

Salama, Mohamed E.; Raman, Sundara; Drew, Mary Jo; Abdel-Raheem, Majdi M.; Mahmood, Muhammad Nateque

doi:10.1016/j.transci.2003.10.005

Cited by 28 publications

(19 citation statements)

References 9 publications

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“…Few studies have evaluated the utility of the PFA‐100 CT in monitoring other therapies. With platelet transfusion therapy, shortening of the PFA‐100 CT by more than 40 s, or its normalization, has been reported to correlate better with cessation of bleeding than corrected platelet count increments [88]. Data are lacking on the utility of the PFA‐100 CT to monitor hemostasis in other clinical situations (e.g.…”

Section: Resultsmentioning

confidence: 99%

Platelet function analyzer (PFA)‐100® closure time in the evaluation of platelet disorders and platelet function

Hayward

Harrison

Cattaneo

et al. 2006

Journal of Thrombosis and Haemostasis

365

274

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Summary. Background: Closure time (CT), measured by platelet function analyzer (PFA‐100®) device, is now available to the clinical laboratory as a possible alternative or supplement to the bleeding time test. Aim: On behalf of the Platelet Physiology Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis (ISTH‐SSC), a working Group was formed to review and make recommendations on the use of the PFA‐100 CT in the evaluation of platelet function within the clinical laboratory. Methods: The Medline database was searched to review the published information on the PFA‐100 CT in the evaluation of platelet disorders and platelet function. This information, and expert opinion, was used to prepare a report and generate consensus recommendations. Results: Although the PFA‐100 CT is abnormal in some forms of platelet disorders, the test does not have sufficient sensitivity or specificity to be used as a screening tool for platelet disorders. A role of the PFA‐100 CT in therapeutic monitoring of platelet function remains to be established. Conclusions: The PFA‐100 closure time should be considered optional in the evaluation of platelet disorders and function, and its use in therapeutic monitoring of platelet function is currently best restricted to research studies and prospective clinical trials.

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Section: Resultsmentioning

confidence: 99%

Platelet function analyzer (PFA)‐100® closure time in the evaluation of platelet disorders and platelet function

Hayward

Harrison

Cattaneo

et al. 2006

Journal of Thrombosis and Haemostasis

365

274

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“…This study also demonstrates the need to improve our ability to monitor PLT efficacy in vivo. As noted, the CCI is an imperfect and artificial method for evaluating whether the PLTs in a PLT transfusion are effective 18,19 . The CCI is not able to specifically determine PLT function.…”

Section: Discussionmentioning

confidence: 99%

The impact of apheresis platelet manipulation on corrected count increment

et al. 2012

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Background Concentrating and washing apheresis platelets (APs) substantially reduce the number of allergic transfusion reactions likely due to removal of plasma. However, these processes may damage platelets. This study evaluated whether concentrating or washing APs decrease the Corrected Count Increment (CCI). Study Design and Methods This retrospective study evaluated individuals who initially received unmanipulated APs and subsequently received concentrated and/or washed APs at a large university hospital between 1998 and 2009. Concentrated units were prepared by reducing the plasma volume of APs by a goal of >67%. Washed units were prepared by washing the APs with 1L normal saline. The CCI (plt × m2/uL) for all transfusions was calculated. Hypothesis testing was performed with Student’s t-tests for continuous variables and chi-square tests for dichotomous variables. Results We evaluated 121 individuals; 46 patients who received unmanipulated, concentrated and then washed APs, 59 patients who received unmanipulated and then concentrated APs; and 16 patients who received unmanipulated and then washed APs. Patient demographics were similar among the three groups. The mean CCI for unmanipulated AP transfusions at 0–2 hours post transfusion were significantly higher than concentrated and washed platelet transfusions (p<0.001). However, when accounting for platelet loss due to manipulation, concentrating APs did not impact the CCI, but the CCI remained significantly lower for washed products at all time points post transfusion (40.7% mean reduction at 20–24 hours, p<0.001). Conclusions Washing APs significantly reduces platelet count recovery and survival, as demonstrated by a significantly reduced CCI.

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“…It remains unclear whether platelets from donors with a transient decrease in platelet function, not attributed to aspirin ingestion, can or cannot reduce bleeding in transfusion recipients. In a recent study, the failure of the PFA‐100® closure times to improve after transfusion was associated with prolonged bleeding [31]. However, in that study, donor platelets were not assessed so a definitive correlation between donor platelet function and outcomes cannot be determined with certainty.…”

Section: Discussionmentioning

confidence: 99%

Platelet function abnormalities in qualified whole‐blood donors: effects of medication and recent food intake

Paglieroni¹,

Janatpour

Gosselin

et al. 2004

Vox Sanguinis

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Platelet function testing to assess effectiveness of platelet transfusion therapy

Cited by 28 publications

References 9 publications

Platelet function analyzer (PFA)‐100® closure time in the evaluation of platelet disorders and platelet function

Platelet function analyzer (PFA)‐100® closure time in the evaluation of platelet disorders and platelet function

The impact of apheresis platelet manipulation on corrected count increment

Platelet function abnormalities in qualified whole‐blood donors: effects of medication and recent food intake

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