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Charles Nicolle Hospital. Platelet transfusion: Experience of the gastro-enterology departement. BEN SAID M , SAID Y , BAHLOUL A , NAJJAR T , GUERMAZI S. Introduction:. Platelet transfusion: complex act needing the consideration of several factors .
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Charles Nicolle Hospital Platelet transfusion: Experience of the gastro-enterology departement BEN SAID M , SAID Y , BAHLOUL A , NAJJAR T , GUERMAZI S
Introduction: • Platelet transfusion: complexactneeding the consideration of severalfactors. • Platelet transfusion in patients with acute or chronicliverdisease: • Curative: active bleeding • Preventive: biopsy, embolization…. • Objective: we report in thisworkourexperiencewithplatelet transfusion in thisparticular situation.
Patients & Methods: • Retrospectivestudy: October 2007 → February 2012. • A factsheetwasdesigned to collect: Epidemiological data Clinical and hematological data Transfusion Indication
Curative platelets transfusion: • Causes:
A clinical response associated with an efficient transfusion Failure: 2/7 patients • Causes:s: • The severity of thrombocytopenia. • An important hypersplenism. 5/7 patients • Efficiencycriteria: • Increase of Plt-count > 20 % • Stop of bleeding
Preventiveplatelets transfusion: • 9 patients (55%): Cirrhosiswithhypersplenism: • Indications: Before: • Associatedwiththrombocytopenia (<50G / L or <100 G/ L if age> 70 years). • Prothrombin time was <50% in 88% of cases
Increase of Plt Count > 20 % (+) no bleeding: Failure: • Efficiency of transfusion: 82 % of cases: → the different acts were held without incidents. 18 % of cases: • Hypersplenism • Insufficient amount of SPC
Comments (1) • Thrombocytopenia in patients withhepatopathies are related to: -hypersplenism -viral etiology of cirrhosis or hepatitis -central origin • Risk of bleedingismajorated by lowprothrombin time
Comments (2): • Efficiency of platelet transfusion islimited by hypersplenism • The failure of curative transfusion of plateletsisobserved in patients withseverethrombopenia, DIC • The minimal platelet count needed in prophylatic transfusion is no wellestablished.
Conclusion: • Curative and preventive transfusion of platelets are not wellcodified in patients withhepatopathies. • Prospective studies are needed to establish guidelines.