Refractoriness to platelet transfusion

Cause

- Common

Fever, Sepsis and/ or infection, Active bleeding, Splenomegaly, Alloimmunization

- Less common

Hematopoietic cell transplanatation - autologous or allogeneic

Disseminated intravascular coagulation

Management

HLA-matched platelets

HLA "compatible" (antigen-negative) platelets

Platelets selected by crossmatch tests

HPA compatible platelets when HPA antibodies are present