ABSTRACT
Surgery, after hematology, is the biggest consumer of homologous platelet concentrates. Platelet transfusion is indicated to prevent or control bleeding associated with deficiencies in platelet number or function. In surgery, general patterns (in function of pre-surgery platelet count) can be adopted in most of the indications for platelets. In emergency situations, and in some particular cases (related to the patient, the type of operation, etc.), the transfusion procedure depends on the team's experience, the results of the available clinical and biological tests, and the drugs. Strict monitoring is required during the transfusion procedure. The efficacy of the transfusion must be controlled 1 h and 24 hours after the transfusion, and a number of factors must be assessed, namely the immunological impact of the transfusion (on red blood cells, leukocytes and platelets) and the occurrence of infectious diseases transmitted via transfusion. In addition, for a possible future transfusion, a strategy must be proposed.
Subject(s)
Blood Loss, Surgical/prevention & control , Platelet Transfusion/standards , Decision Trees , Humans , Monitoring, Physiologic , Platelet Transfusion/adverse effectsABSTRACT
In Besançon, we carried out 40 plateletphereses with the latest model of the Fresenius cell separator AS 104 to check this new system against the new generation of cell separators, according to the following criteria: less than 2x10 6 leukocytes (before filtration) and more than 5x10 11 platelets. The results show that platelet concentrates contained 5.04+/-0.88x10 11 platelets in a total volume of 435+/-113 mL. The mean platelet recovery was 40.95+/-4.86% (from 31.7 to 51.6). The leukocyte content was 2.28+/-5.48x10 6 and the red blood cell contamination was 3.48+/-2.38x10 8. The quality of the platelets was very satisfactory. There was no problem with donor biocompatibility or procedure safety, few adverse donor reactions (0.6%) and good therapeutic efficiency of platelet concentrates.
