Thrombozytentransfusion: Klinik, Kontrollen und Komplikationen

Thrombocytopenia is the most common cause of bleeding tendency, and, if due to impaired platelet production, is best treated by platelet transfusions. Prophylactic transfusions for asymptomatic patients should be considered if platelet count is below 20000/μl. However, if bleeding occurs or surgery is inevitable, platelet count should be maintained above 50000/μl. The benefit of platelet transfusions has to be balanced against risks like fever, infections and haemolysis. The effectiveness of platelet transfusions should be examined after 1 and 24 hrs by measuring the corrected count increment (CCI). Not only alloimmunization is a reason for unsatisfactory platelet increments. A poor CCI can also be due to fever, sepsis, hepato-splenomegaly or special drugs, which must be taken into account when assessing the demand for platelet transfusions.