Antiplatelet agents are at risk for bleeding complications, the management of which differs depending on the clinical situation and on the antiplatelet agent itself. Neutralization of antiplatelets is sometimes necessary, most often leading to platelet transfusion, although the benefit of this strategy is poorly documented. In addition, if platelet transfusion corrects the platelet inhibition induced by aspirin and probably by clopidogrel and prasugrel, it does not neutralize ticagrelor, as a consequence of its pharmacological properties. The clinical benefit of platelet transfusion is limited, and the most recent studies are challenging it. However, it is indicated on a perioperative basis for surgeries with high hemorrhagic risk and is discussed in severe hemorrhages. The neutralization of ticagrelor is a concern and the antidote currently under development may be a solution. In all cases, other therapeutic solutions may be considered, such as administration of desmopressin, tranexamic acid or activated factor VII.
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http://dx.doi.org/10.1016/j.tracli.2017.05.014 | DOI Listing |
Int J Hematol
January 2025
Division of Hematology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
The study aimed to investigate the therapeutic effect of various initial treatments incorporating glucocorticoid (GC) in TAFRO syndrome (thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly). Cases of TAFRO syndrome up to November 2023 were retrospectively collected. Overall survival (OS) and resistance to GC therapy were assessed, with resistance analyzed based on the time to the next treatment or death (TTNTD).
View Article and Find Full Text PDFCase Rep Womens Health
March 2025
Sakai City Medical Center, 1-1-1, Ebaraji-cho, Nishi-ku, Sakai, Osaka 593-8304, Japan.
Intramural pregnancy (IMP) is an extremely rare form of ectopic pregnancy (EP), typically associated with previous uterine trauma, adenomyosis, or assisted reproductive technology (ART), such as embryo transfer (ET). Despite its potentially life-threatening nature, the absence of definitive preoperative diagnostic criteria for IMP complicates its early detection and management, especially in patients without known risk factors. Additionally, management becomes more challenging when there is an elevated risk of hemorrhage.
View Article and Find Full Text PDFInt J Hematol
January 2025
Department of Blood Transfusion, Osaka University Hospital, Osaka, Japan.
Fostamatinib had superior efficacy to a placebo and acceptable safety profiles for at least 1 year in a phase 3 study of Japanese patients with primary immune thrombocytopenia. Here, we report the 3-year safety and efficacy of fostamatinib in that study. Data from 33 patients who received at least one dose of fostamatinib were analyzed.
View Article and Find Full Text PDFHeliyon
January 2025
Medical Faculty of Suleyman Demirel University, Blood Transfusion Center, Turkey.
Background: Rapid, reproducible, and noninvasive diagnostic methods like Ultrasonography (US) and plethysmographic measurements such as the perfusion index (PI) and pleth variablity index (PVI) have great potential value for emergency trauma cases in which blood loss needs to be recognized quickly and accurately.
Objectives: We planned this study to evaluate the utility of US, PI, and PVI in detecting early-stage hemorrhage and mimicking volume replacement using a platelet apheresis model.
Methods: This prospective, observational study included 46 healthy platelet apheresis volunteers who met inclusion criteria.
Hamostaseologie
January 2025
Center for Clinical Transfusion Medicine Tuebingen, Tuebingen, Germany.
In this article, our goal is to offer an introduction and overview of the diagnostic approach to inherited platelet function defects (iPFDs) for clinicians and laboratory personnel who are beginning to engage in the field. We describe the most commonly used laboratory methods and propose a diagnostic four-step approach, wherein each stage requires a higher level of expertise and more specialized methods. It should be noted that our proposed approach differs from the ISTH Guidance on this topic in some points.
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