Platelet concentrates:

• These are prepared either by centrifugation of whole blood or by plateletpheresis of blood from single donors using cell separators.
• They may be stored for up to 7 days at 22°C with agitation and bac- terial culture to minimize the risk of bacterial transmission.

Platelet transfusion: active bleeding

Active bleeding

• Offer platelet transfusions to patients with a platelet count of <30 x 10 with clinically significant bleeding (World Health organisation bleeding grade 2- e.g. haematemesis, melaena, prolonged epistaxis)
• Platelet thresholds for transfusion are higher (maximum < 100 x 10) for patients with severe bleeding (World Health organisation bleeding grades 3&4), or bleeding at critical sites, such as the CNS.

It should be noted that platelet transfusions have the highest risk of bacterial contamination compared to other types of blood product.

Pre-invasive procedure (prophylactic)

Platelet transfusion for thrombocytopenia before surgery/ an invasive procedure. Aim for plt levels of:

• 50×10/L for most patients

• 50-75×10/L if high risk of bleeding

• 100×10/L if surgery at critical site

If no active bleeding or planned invasive procedure

A threshold of 10 x 10 except where platelet transfusion is contradindicated or there are alternative treatments for their condition

For example, do not perform platelet transfusion for any of the following conditions:

• Chronic bone marrow failure
• Autoimmune thrombocytopenia
• Heparin-induced thrombocytopenia, or