On July 16th, 2000 a member of the CBBS e-Network asked that the following question be distributed to the e-Network:

Do facilities refrain from transfusing platelets during the performance of a hemodialysis procedure? Historically the inquiring member's facility has recommended that platelets be transfused either prior to or following hemodialysis, but the inquiring member has been unable to find a reference stating why platelets should not be transfused during the actual hemodialysis procedure. The member wanted to know what the transfusion practice was at other hospitals or hemodialysis centers, and if anyone knew of a reference that addressed the best approach for platelet transfusion therapy for patients who are on a hemodialysis treatment regimen.

One individual responded with the following guidance: There is no policy written in stone, but it always seems prudent to wait until after hemodialysis has been concluded, presuming that there is not an emergency need for transfusion. The reason to wait until after the hemodialysis procedure is concluded is to avoid problems associated with platelet dysfunction that might be caused by uremia or by the contact of transfused platelets with the dialysis membrane and/or heparin.

Please submit comments to the e-Network Forum.

Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator