Here are the some recommendations of the use of platelet transfusion.

If you go to BCSH guidelines, you can get the full version.

Prophylaxis for surgery

• Bone marrow aspiration and biopsy may be performed inpatients with severe thrombocytopenia without plateletsupport, providing that adequate surface pressure isapplied (grade C, level IV).

• For lumbar puncture, epidural anaesthesia, gastroscopyand biopsy, insertion of indwelling lines, transbronchialbiopsy, liver biopsy, laparotomy or similar procedures, theplatelet count should be raised to at least 50 x 10⁹ / l(grade B, level III).

• For operations in critical sites such as the brain or eyes,the platelet count should be raised to 100 x 10⁹/ l (gradeC, level IV).

• It should not be assumed that the platelet count will risejust because platelet transfusions are given, and apreoperative platelet count should be checked to ensurethat the above thresholds have been reached.

Disseminated intravascular coagulation (DIC)

Platelet transfusions are a part of the management of acute  DIC, where there is bleeding associated with thrombocytopenia, in addition to management of the underlying disorder and coagulation factor replacement (BCSH, 1992).

Recommendations (grade C, level IV).

• Frequent estimation of the platelet count and coagulation screening tests should be carried out.
• There is no consensus on a target platelet count, but to aim to maintain the platelet count > 50x 10⁹ / l, as in massive blood loss, would seem to be reasonable practice (Consensus Conference on Platelet Transfusion, 1998).
• In chronic DIC, or in the absence of bleeding, platelet transfusions should not be given merely to correct a low platelet count.

1997).

CONTRAINDICATIONS TO PLATELET TRANSFUSIONS

Thrombotic thrombocytopenic purpura (TTP)

Guidelines on the diagnosis and management of the thrombotic microangiopathic haemolytic anaemias have
been published (BCSH, 2003b). Platelet transfusions are contraindicated unless there is life-threatening haemorrhage, as they have been temporarily associated with exacerbation of TTP (Harkness et al, 1981; Gordon et al,
1987).

Heparin-induced thrombocytopenia (HIT)

HIT is a drug-induced immune thrombocytopenia that is frequently associated with severe thrombosis (Warkentin
et al, 1998). Platelet transfusions should not be administered as acute arterial thrombosis can result (Babcock et al, 1976; Cimo et al, 1979).

Full guideline in PDF file

Note: Guideline may be changed from time to time. So you may need to check with original websites.