Perioperative platelet transfusion in infantile with Kasabach-Merritt phenomenon insensitive to glucocorticoids
10.3760/cma.j.issn.1009-4598.2018.05.007
- VernacularTitle: 大剂量单次输注血小板在激素不敏感型卡梅现象患儿术前的应用
- Author:
Xiaonan GUO
1
;
Xiaoshuang ZHU
;
Dakan LIU
;
Yubin GONG
;
Hongzhao LEI
;
Changxian DONG
Author Information
1. Department of Hemangioma & Vascular Malformation, Henan Provincial People′s Hospital, Zhengzhou 450003, China
- Publication Type:Journal Article
- Keywords:
Kasabach-Merritt phenomenon;
Infant;
Platelet transfusion
- From:
Chinese Journal of Plastic Surgery
2018;34(5):356-359
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the safety and effectiveness of sufficient, short-term platelet (PLT) transfusion for the surgery preparation of the infantile patients with Kasabach-Merritt phenomenon, who were insensitive to glucocorticoids.
Methods:The infantile cases were retrospectively analyzed during May 2011 to December 2016, who were clinically diagnosed as KMP and insensitive to glucocorticoids, received PLT transfusion and surgical resection. PLT transfusion in patients whose PLTC was less than 30×109/L, was 0.3 therapeutic dose(TD)/kg, and 0.2 TD/kg in PLTC≥30×109/L group. The maximum was 1 TD.Criteria of the PLT transrusion: 1 hour after the transfusion, the PLT count (PLTC) were tested and the corrected count increment of platelet (CCI) and practical platelet recovery (PPR) was calculated. PLTC ≥100×109/L, CCI>7.5×109/L and PPR>30% were defined as effective; while PLTC=(50-99)×109/L, CCI>7.5×109/L and PPR>30% as partial effective; PLTC<50×109/L, or CCI≤7.5×109/L, or PPR ≤30% were defined as ineffective. By reviewing the method and response of their PLT infusions, to figure out the most effective way in rising PLT, as a part of pre-operation treatment.
Results:There were 46 cases in the research. Based on the PLTC, CCI and PPR 1 hour after PLT transfusion, there were 44 effective transfusion, 2 patients with partial effectiveness, and no ineffective case. There was no allergic or heart failure happened in any cases. No critical potential complications of PLT transfusion occurred, including fluid and iron overload, alloimmunization to human leukocyte antigen and/or PLT antigen.
Conclusions:Pre-operative sufficient and short-term PLT infusions are more effective than low dose and long-term ones. They can create a more optimistic opportunity for surgical resections.
