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KMID : 0981820090290020158
Korean Journal of Laboratory Medicine
2009 Volume.29 No. 2 p.158 ~ p.162
Reduction of the Platelet Transfusion Dose and Its Effects
Baek Eun-Jung

Lee Yang-Soon
Kim Hyo-Sik
Bae In-Cheol
Kim Hyun-Ok
Abstract
Background : In Korea, a platelet transfusion dose (TD) of 8 units of platelet concentrates (PC) is usually used. To minimize the shortage of blood products and transfusion-related adverse reactions, the TD has been changed from 8 to 6 units in 2006 in our hospital. Here, we analyzed the dose reduction effect on patients¡¯ platelet counts and transfusion frequency.

Methods : We compared the amount of issued PC, platelet counts before and after transfusion, post-transfusion platelet increments, and transfusion frequencies in patients who were transfused with 8 PC in 2006 and 6 PC in 2008.

Results : Despite an increase in the number of admitted patients by 20% in 2008 with a disease distribution similar to that in 2006, the number of issued PC in 2008 was decreased by 26.6% compared to that in 2006. In 2008, post-transfusion platelet counts, pre-transfusion platelet counts in patients transfused with 320 mL whole blood-derived PC, and platelet increments in patients transfused with 400 mL whole blood-derived PC were significantly decreased. However, the mean transfusion frequency per one month was not significantly different, 4.3 times in 2006 and 4.7 in 2008.

Conclusions : By implementing a policy of platelet TD restriction, the amount of total issued PC was markedly decreased. Although post-transfusion platelet counts were decreased, the transfusion frequency in a month was not significantly increased. The restriction of platelet TD was helpful for increasing physicians¡¯ recognition of blood shortage while achieving similar transfusion effects. We conclude that 6 units of PC would be a better guideline for the platelet TD.
KEYWORD
Platelet, Transfusion dose, Adequate transfusion, Transfusion guidelines
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