Current Trends in Platelet Transfusion – Transfusion Practices in Europe

Platelet transfusion practices in Europe are summarized based on survey questionnaire returns from 36 centers in 17 countries. In marrow hypoplasia the platelet transfusion trigger varied from 10,000 to 20,000/µl with a minority at 5,000/µl. These levels increased up to 50,000/µl in case of signs of major bleeding. In surgery levels of 50,000 to 100,000/µl were desirable with attempts to maintain postoperative levels of 30,000 to 50,000/µl for up to one week. A large majority of centers used random-pooled platelet concentrates (RPC) for surgical patients, while apheresis platelets were used by a small majority for chronic thrombocytopenic patients. HLA-matched platelets were used in most cases for immunized or refractory patients. An increasing majority prepares RPC by the buffy-coat technique. There is a tendency to store apheresis platelets for shorter times. Leukocyte-depleted platelets were used primarily for refractory chronic thrombocytopenic patients, although levels considered effective rang edfrom < 106 to < 108 About half the centers used leukocyte-depleted platelets in lieu of cytomegalovirus (CMV)-seronegative platelets. A large majority irradiated products for patients at risk of GvHD, although irradiation doses varied widely. The dose of platelets per transfusion also varied widely.