Why is platelet transfusion contraindicated in ITP?

Why is platelet transfusion contraindicated in ITP?

Platelet transfusions are generally contraindicated in ITP (due to their rapid destruction by the underlying auto-immune process). However, transfused platelets may provide at least temporary hemostatic benefit in the event of serious or life-threatening bleeding.

Do you transfuse platelets in ITP?

These data suggest that platelet transfusions are administered frequently in hospitalized patients with ITP in those who have bleeding complications and also in those who have epistaxis in the absence of a major bleed.

Why a patient would need a splenectomy after a diagnosis of ITP?

Why remove the spleen? In people with ITP the immune system treats platelets as foreign and destroys them. The spleen is responsible for removing these damaged platelets and therefore removal of the spleen can help to keep more platelets circulating in the body.

When should you avoid platelet transfusion?

Platelet transfusions are contraindicated in patients with thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), or heparin induced thrombocytopenia (HIT).

When is platelet transfusion indicated in ITP?

Therefore, current American Society of Hematology guidelines recommend that platelet transfusion in ITP patients be reserved for those with catastrophic hemorrhage or having concurrent surgery.

What does IVIG do for ITP?

In patients with ITP, Intravenous immunoglobulin (IVIG) increases the platelet count by decreasing the destruction of platelets in your spleen. IVIG may also work in patients with or without a spleen by binding to and neutralizing the antibodies responsible for destroying platelets.

How is platelet transfusion administered?

Administer via a volumetric pump or syringe driver to ensure accurate volume delivered. Standard 170-200 micron filter either in-line or on transfer to syringe. Use a new blood administration filter (170 – 200 micron) when administering platelets.

What happens to platelets after splenectomy?

An increase in blood leukocytes can occur following a splenectomy. The post-splenectomy platelet count may rise to abnormally high levels (thrombocytosis), leading to an increased risk of potentially fatal clot formation.

Can ITP return after a splenectomy?

Therefore ITP is the most common indication for elective splenectomy, unfortunately, even when surgery successfully achieves platelets count remission, there is not guarantee that the disease will not recur. A review of the literature shows ITP recurrence following splenectomy ranging between 18% to 38% (17-9).

How long does it take for platelets to increase after transfusion?

The normal response to platelet transfusion is an immediate increase in the platelet count that is maximal at about 10 min to 1 h post-transfusion. Following this, there is a steady linear decrease in the platelet count, which usually returns to baseline at about 72 h post-transfusion.

How long should platelets be transfused over?

How does a splenectomy help ITP?

Splenectomy removes the primary site of platelet clearance and autoantibody production and offers the highest rate of durable response (50% to 70%) compared with other ITP therapies.