Platelet transfusion: a systematic review of the clinical evidence

Kumar, Ambuj; Mhaskar, Rahul; Grossman, Brenda J.; Kaufman, Richard M.; Tobian, Aaron A.R.; Kleinman, Steven; Gernsheimer, Terry B.; Tinmouth, Alan; Djulbegovic, Benjamin; Panel, Aabb Platelet Transfusion Guidelines

doi:10.1111/trf.12943

Cited by 138 publications

(130 citation statements)

References 68 publications

(130 reference statements)

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“…In hypoproliferative thrombocytopenia, four RCTs inclusive of over 1,000 patients show no differences in all-cause or bleeding-related mortality between patients transfused platelets and those not receiving platelets (101). For procedural purposes in critical care units, there appears to be no benefit to prophylactic platelet transfusion for central venous catheter placements, thoracentesis, or paracentesis in thrombocytopenic patients(102).…”

Section: Conmentioning

confidence: 99%

Is Coagulopathy an Appropriate Therapeutic Target During Critical Illness Such as Trauma or Sepsis?

Moore

Winfield²,

Aibiki³

et al. 2017

Shock

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Coagulopathy is a common and vexing clinical problem in critically ill patients. Recently, major advances focused on the treatment of coagulopathy in trauma and sepsis have emerged. However, the targeting of coagulopathy with blood product transfusion and drugs directed at attenuating the physiologic response to these conditions have major potential risk to the patient. Therefore, the identification of coagulopathy as a clinical target is an area of uncertainty and controversy. In order to analyze the state of the science regarding coagulopathy in critical illness, a symposium addressing the problem was organized at the 39th annual meeting of the Shock Society in the summer of 2016. This manuscript synthesizes the viewpoints of the four expert panelists at the debate and presents an overview of the potential positive and negative consequences of targeting coagulopathy in trauma and sepsis.

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Section: Conmentioning

confidence: 99%

Is Coagulopathy an Appropriate Therapeutic Target During Critical Illness Such as Trauma or Sepsis?

Moore

Winfield²,

Aibiki³

et al. 2017

Shock

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show abstract

“…The clinical challenge Donor-derived platelets are used for the primary purposes of (1) standard transfusions requiring large numbers of quiescent prophylaxis platelets responsive to vascular injury 1 and (2) acute (often posttrauma) transfusional needs requiring platelets that are immediately responsive for incorporation into sites of injury. 2 These clinical needs for platelet transfusions are extensive and increasing.…”

Section: Introductionmentioning

confidence: 99%

Understanding platelet generation from megakaryocytes: implications for in vitro–derived platelets

Sim

Poncz

Gadue

et al. 2016

Blood

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Platelets are anucleate cytoplasmic discs derived from megakaryocytes that circulate in the blood and have major roles in hemostasis, thrombosis, inflammation, and vascular biology. Platelet transfusions are required to prevent the potentially life-threatening complications of severe thrombocytopenia seen in a variety of medical settings including cancer therapy, trauma, and sepsis. Platelets used in the clinic are currently donor-derived which is associated with concerns over sufficient availability, quality, and complications due to immunologic and/or infectious issues. To overcome our dependence on donor-derived platelets for transfusion, efforts have been made to generate in vitro–based platelets. Work in this area has advanced our understanding of the complex processes that megakaryocytes must undergo to generate platelets both in vivo and in vitro. This knowledge has also defined the challenges that must be overcome to bring in vitro–based platelet manufacturing to a clinical reality. This review will focus on our understanding of committed megakaryocytes and platelet release in vivo and in vitro, and how this knowledge can guide the development of in vitro–derived platelets for clinical application.

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“…A recent systematic review of the clinical evidence of platelet transfusions by the American Association of Blood Banks platelet transfusion guidelines panel highlighted the paucity of data guiding the use of platelet transfusions in these disorders. 24 This study, using a nationally representative hospital discharge database, assessed the current platelet transfusion practices in hospitalized patients with these platelet consumptive disorders and their association, if any, with various clinical outcomes including bleeding, venous and arterial thrombotic events, acute myocardial infarction (AMI), stroke, and overall survival. The online version of this article contains a data supplement.…”

Section: Introductionmentioning

confidence: 99%

Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality

Goel

Ness²,

Takemoto

et al. 2015

Blood

169

115

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Platelet transfusion: a systematic review of the clinical evidence

Abstract: We provide a comprehensive assessment of evidence on the use of PLT transfusions in a variety of clinical settings. Our report summarizes current knowledge and identifies gaps to be addressed in future research.

Cited by 138 publications

References 68 publications

Is Coagulopathy an Appropriate Therapeutic Target During Critical Illness Such as Trauma or Sepsis?

Is Coagulopathy an Appropriate Therapeutic Target During Critical Illness Such as Trauma or Sepsis?

Understanding platelet generation from megakaryocytes: implications for in vitro–derived platelets

Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality

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