Test Overview
Test Methodology

Evaluation by the blood bank house officers to determine if further testing should be performed to determine immune-based platelet refractoriness.

Test Usage

Platelet refractoriness evaluation should be ordered on patients who show consistent failure to respond to transfused platelets and in whom significant non-immune causes of platelet refractoriness have been excluded. If the initial evaluation is suggestive of immune refractoriness, the care team will be contacted to draw 2 pink-top tubes for further evaluation of platelet refractoriness by platelet cross-match with random donors performed at the Red Cross in Detroit. If the cross-match evaluation shows a high degree of immune refractoriness, the patient’s previously drawn blood will be evaluated for anti-HLA antibodies. If this evaluation shows a high degree of anti-HLA antibodies, then HLA-matched platelets will be ordered for the patient.

Reference Range *

Not platelet refractory, non-immune platelet refractory, or suspicious for immune platelet refractory.

Test Details
Days Set Up
Monday - Friday
Analytic Time

1 day

Soft Order Code
PLTC
Synonyms
  • PLT CONS
  • Platelet Refractory Consult
  • Platelet Refractoriness Evaluation
Laboratory
Blood Bank
Section
Blood Bank
Specimen Requirements
Collection Instructions

This test is available only for University of Michigan registered patients.

Contraindications
Platelet refractoriness evaluation should not be ordered on patients who have a known significant non-immune cause of platelet refractoriness.
Rejection Criteria
Platelet refractoriness evaluation may be cancelled at the discretion of the blood bank physician if there are not at least 3 platelet transfusions with 1-hour post-transfusion platelet levels showing an increase of less than 10,000/µL. Platelet refractoriness evaluation may be cancelled if there are significant non-immune causes of platelet refractoriness. Non-immune causes include splenomegaly, fever, infection (sepsis), ongoing bleeding, graft-versus host disease, transplant patients, diffuse intravascular coagulopathy, veno-occlusive disease, and some medications. Medications known to cause non-immune platelet refractoriness include antibiotics (beta-lactams and vancomycin) and anti-fungals (amphotericin B), GMCSF, interferon, anti-thymocyte globulin, heparin, fibrinolytic agents, nitroglycerin, NSAIDS, Beta-blockers, calcium-channel blockers, quinidine, dypiriamole, phenothiazines, tricyclic antidepressants, anaesthetic agents, radiographic contrast agent.
Additional Information

Please refer to Platelet Refractoriness Evaluation Supplemental Information available online at http://www.pathology.med.umich.edu/handbook/Tables/Platelet_Refractorin… for additional information.

Billing
NY State Approved
No