Platelet Transfusion

Epidemiology

  • Fever (without hemolysis) is most common reaction to transfused platelets (occur in 5-30% of transfusions)
  • Fever is more common with platelet transfusion than PRBC transfusion
  • Febrile reactions are more common with older platelets (possibly due to production of bioactive substance over time) and those with higher numbers of leukocytes

Physiology

  • Fever due to reaction to bioactive substance (possibly an Interleukin) in transfused plasma in platelets (NEJM: 1994: 331: 625-628) and possibly some anti-leukocyte antibodies present in recipient (which act against residual leukocytes in platelets)

Clinical

  • Most febrile reactions are mild
  • Rigors
  • Fever/Chills (see [[Fever]])
  • Nausea

Treatment

  • Remove all plasma prior to transfusion

References

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