The use of donor platelets in the hospital of emergency medicine

Introduction. A multidisciplinary emergency hospital is a significant consumer of platelet concentrates (PCs). The specificity of requirements, logistics, and clinical use of PCs in multidisciplinary hospitals may affect the strategy for procuring this blood component.

Aim: to analyze the practice of PC transfusion in a multidisciplinary hospital providing emergency and urgent care to the population.

Materials and methods. In a retrospective observational study spanning over a 5-year period, 7,049 PC transfusions were examined in an emergency care multidisciplinary hospital. The study analyzed the indications for PC transfusion, PC efficacy, transfusion load on the recipient, urgency of performing PC transfusion, group compatibility of used PCs, PC type, and compared the corrected count increment (CCI) 24 hours after transfusion of various PC types.

Results. Between 23 % and 29 % of all PCs were transfused to patients who were admitted with polytrauma and massive blood loss, 18–27% were transfused to patients with septic complications, 8–13 % to patients during preparation and postoperative management for liver transplantation, 21 % to patients who underwent ECMO. Emergency indications accounted for 31.8–40.7% of PC transfusions. In 61.5 % of cases, the indication was hemorrhagic syndrome in combination with thrombocytopenia. AB0-identical transfusions were performed in 4,723 (67.1 %) cases. There were no significant differences in CCI when using apheresis, pooled or cryopreserved PCs.

Conclusion. When planning the work of hospitals providing emergency medical care to patients with surgical and traumatological profiles, the need for PC transfusions in 1.5–2 % of patients should be considered. Emergency supply can be facilitated using the “platelet management” tools: a reserve of universal donor PCs-prepared in additive solution or obtained apheresis from AB-group donors or via pooling from O-group donorsand cryopreserved PCs.

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