Trigger for platelet transfusion

Background and Objectives: The terms 'pratelet transfusion trigger' are use d in the scientific literature to indicate a value of the platelet count ab ove which prophylactic platelet transfusion is usually not indicated. Most clinicians share the currently prevalent consensus published in several gui delines that a platelet transfusion trigger of 10,000 platelets per microli ter is safe in stable oncohematology recipients carefully monitored at both the clinical and laboratory levels, whereas higher values may be necessary in patients with high fever, infection, splenomegaly, rapid platelet count decrease. on drugs able to affect platelet function and survival, in cases undergoing invasive maneuvers and in some pediatric patients such as prema ture newborns. The safety of this policy is supported by the results obtain ed in several randomized clinical trials and prolonged observational studie s. Lowering the platelet transfusion trigger from the traditional value set at 20,000 platelets per microliter to the currently recommended value of 1 0,000 per microliter further stresses the importance of high-quality. suffi cient and prompt platelet availability and close cooperation between clinic ians and blood transfusion specialists. Furthermore, it requires a clear un derstanding of the discriminatory power of current automated hematology cou nters at very Low platelet counts. In the surgical setting, where randomize d clinical trials on the most appropriate platelet transfusion trigger are largely missing, current guidelines propose to maintain higher platelet cou nt values (50,000-100,000 per microliter) during surgery and in the early p ostoperative period.