Investigating the Refractory Platelet Transfusion: Understanding the Underlying Factors, Diagnosis, and Effective Treatment Strategies



E Razani ELHAM ; M Khiabani Rad MARYAM ; E Larki Trok EHSAN ; F Bahmani FOUROZAN
Source: Iranian Journal of Blood and Cancer Published:2025

Abstract

This review article provides a comprehensive overview of platelet transfusion-refractory (PTR), a condition in which patients do not respond well to platelet transfusions, leading to increased bleeding and complications. It discusses various aspects of PTR such as its causes, prevention, diagnosis, management, and potential complications. While immune-mediated reactions are the primary cause, non-immunologic, patient-related, and donor-related factors can also contribute. Preventing PTR involves methods such as HLA matching, platelet count monitoring, and prophylactic transfusions; however, alternative approaches require further research. Accurate diagnosis is crucial, with treatment strategies depending on the cause often requiring platelet transfusions from HLA-matched donors or immunosuppressive therapies. Complications included bleeding, infection, and adverse drug reactions, highlighting the need for proper management and monitoring. Future research should focus on patient-specific risk factors, alternative prevention methods, and blood product safety. Understanding immune-mediated reactions and other causes, prevention, diagnosis, management, and potential complications can improve outcomes in patients needing platelet transfusions. In conclusion, PTR is a complex condition that healthcare professionals must handle carefully. Ongoing research is crucial to advancing knowledge, enhancing care, and improving patient outcomes. © 2025 Elsevier B.V., All rights reserved.