{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:34:57Z","timestamp":1791480897930,"version":"4.3.4"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>Objective\u2003A few patients in neonatal intensive care units (NICU) receive numerous platelet transfusions. These patients can become refractory, defined as transfusions of \u226510\u2009mL\/kg failing to increase the platelet count by at least 5,000\/\u00b5L. Causes of, and best treatments for, platelet transfusion refractoriness in neonates have not been defined.<\/jats:p>\n                  <jats:p>Study Design\u2003Multi-NICU multiyear retrospective analysis of neonates receiving &gt;25 platelet transfusions.<\/jats:p>\n                  <jats:p>Results\u2003Eight neonates received 29 to 52 platelet transfusions. All eight were blood group O. Five had sepsis, four were very small for gestational age, four had bowel resections, two Noonan syndrome, two had cytomegalovirus infection. All eight had some (19\u201373%) refractory transfusions. Many (2\u201369%) of the transfusions were ordered when the platelet count was &gt;50,000\/\u00b5L. Higher posttransfusion counts occurred after ABO-identical transfusions (p\u2009=\u20090.026). Three of the eight had late NICU deaths related to respiratory failure; all five survivors had severe bronchopulmonary dysplasia requiring tracheostomy for prolonged ventilator management.<\/jats:p>\n                  <jats:p>Conclusion\u2003Neonates who are high users of platelet transfusions appear to be at high risk for poor outcomes, especially respiratory failure. Future studies will examine whether group O neonates are more likely to develop refractoriness and whether certain neonates would have a higher magnitude of posttransfusion rise if they received ABO-identical donor platelets.<\/jats:p>\n                  <jats:p>Key Points<\/jats:p>","DOI":"10.1055\/a-2073-3848","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T19:18:40Z","timestamp":1681413520000},"page":"e1769-e1774","source":"Crossref","is-referenced-by-count":7,"special_numbering":"S","title":["Neonatal Intensive Care Unit Patients Receiving More Than 25 Platelet Transfusions"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7946-0290","authenticated-orcid":false,"given":"Timothy M.","family":"Bahr","sequence":"additional","affiliation":[{"name":"Obstetric and Neonatal Operations, Intermountain Healthcare, Murray, Utah"},{"name":"Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin K.","family":"Ohls","sequence":"additional","affiliation":[{"name":"Obstetric and Neonatal Operations, Intermountain Healthcare, Murray, Utah"},{"name":"Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah J.","family":"Ilstrup","sequence":"additional","affiliation":[{"name":"Intermountain Healthcare Transfusion Services and Department of Pathology, Intermountain Medical Center, Murray, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Christensen","sequence":"additional","affiliation":[{"name":"Obstetric and Neonatal Operations, Intermountain Healthcare, Murray, Utah"},{"name":"Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,5,19]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1097\/MOH.0000000000000542","article-title":"Neonatal and pediatric platelet transfusions: current concepts and controversies","volume":"26","author":"R M Patel","year":"2019","journal-title":"Curr Opin Hematol"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1001\/jamapediatrics.2016.0507","article-title":"Platelet transfusion practices among very-low-birth-weight infants","volume":"170","author":"K A Sparger","year":"2016","journal-title":"JAMA Pediatr"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1038\/s41372-021-01033-6","article-title":"Implementation of a neonatal platelet transfusion guideline to reduce non-indicated transfusions using a quality improvement framework","volume":"41","author":"P E Davenport","year":"2021","journal-title":"J Perinatol"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1111\/j.1537-2995.2008.02074.x","article-title":"Very high users of platelet transfusions in the neonatal intensive care unit","volume":"49","author":"M L Dohner","year":"2009","journal-title":"Transfusion"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.hoc.2016.01.008","article-title":"Management of the platelet refractory patient","volume":"30","author":"S K Forest","year":"2016","journal-title":"Hematol Oncol Clin North Am"},{"issue":"11","key":"ref6","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1046\/j.1537-2995.2003.00529.x","article-title":"Factors influencing moderate to severe reactions to PLT transfusions: experience of the TRAP multicenter clinical trial","volume":"43","author":"H Enright","year":"2003","journal-title":"Transfusion"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1182\/hematology.2020000135","article-title":"Does ABO and RhD matching matter for platelet transfusion?","volume":"2020","author":"N M Dunbar","year":"2020","journal-title":"Hematology (Am Soc Hematol Educ Program)"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1097\/MOH.0b013e328358b135","article-title":"ABO incompatible platelets: risks versus benefit","volume":"19","author":"N M Dunbar","year":"2012","journal-title":"Curr Opin Hematol"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.transci.2009.10.013","article-title":"ABO-mismatched platelet transfusions: strategies to mitigate patient exposure to naturally occurring hemolytic antibodies","volume":"42","author":"C D Josephson","year":"2010","journal-title":"Transfus Apheresis Sci"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1097\/PCC.0000000000001779","article-title":"Effects of ABO matching of platelet transfusions in critically ill children","volume":"20","author":"M E Nellis","year":"2019","journal-title":"Pediatr Crit Care Med"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1038\/s41372-018-0048-4","article-title":"ABO hemolytic disease of the fetus and newborn: thirteen years of data after implementing a universal bilirubin screening and management program","volume":"38","author":"R D Christensen","year":"2018","journal-title":"J Perinatol"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.tmrv.2016.05.008","article-title":"Hemolytic disease of the fetus and newborn: modern practice and future investigations","volume":"30","author":"J E Hendrickson","year":"2016","journal-title":"Transfus Med Rev"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1002\/jca.20072","article-title":"Acute hemolytic transfusion reaction in a pediatric patient following transfusion of apheresis platelets","volume":"20","author":"S Sapatnekar","year":"2005","journal-title":"J Clin Apher"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1542\/peds.2007-2850","article-title":"Platelet transfusion practices among neonatologists in the United States and Canada: results of a survey","volume":"123","author":"C D Josephson","year":"2009","journal-title":"Pediatrics"},{"issue":"12","key":"ref15","doi-asserted-by":"crossref","first-page":"2634","DOI":"10.1111\/j.1537-2995.2011.03208.x","article-title":"Platelet transfusions in neonates: practices in the United States vary significantly from those in Austria, Germany, and Switzerland","volume":"51","author":"M Cremer","year":"2011","journal-title":"Transfusion"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1056\/NEJMoa1807320","article-title":"Randomized trial of platelet transfusion thresholds in neonates","volume":"380","author":"A Curley","year":"2019","journal-title":"N Engl J Med"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.tmrv.2021.06.003","article-title":"Neonatal platelet transfusions: starting again","volume":"35","author":"C M Moore","year":"2021","journal-title":"Transfus Med Rev"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1056\/NEJMe1813419","article-title":"Platelet transfusions in neonates - less is more","volume":"380","author":"M C Sola-Visner","year":"2019","journal-title":"N Engl J Med"},{"issue":"26","key":"ref19","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1182\/blood.2019000899","article-title":"Preterm neonates benefit from low prophylactic platelet transfusion threshold despite varying risk of bleeding or death","volume":"134","author":"S F Fustolo-Gunnink","year":"2019","journal-title":"Blood"},{"issue":"10","key":"ref20","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1080\/17474086.2019.1657824","article-title":"Platelet and red cell transfusions for neonates: lifesavers or Trojan horses?","volume":"12","author":"S F Fustolo-Gunnink","year":"2019","journal-title":"Expert Rev Hematol"},{"issue":"12","key":"ref21","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1002\/pbc.24682","article-title":"Drug-induced thrombocytopenia in children","volume":"60","author":"J A Reese","year":"2013","journal-title":"Pediatr Blood Cancer"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1182\/asheducation-2009.1.153","article-title":"Drug-induced thrombocytopenia: pathogenesis, evaluation, and management","volume":"2009","author":"J N George","year":"2009","journal-title":"Hematology (Am Soc Hematol Educ Program)"},{"issue":"12","key":"ref23","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1182\/bloodadvances.2019000279","article-title":"Romiplostim for the management of pediatric immune thrombocytopenia: drug development and current practice","volume":"3","author":"C E Neunert","year":"2019","journal-title":"Blood Adv"},{"issue":"06","key":"ref24","doi-asserted-by":"crossref","first-page":"e27706","DOI":"10.1002\/pbc.27706","article-title":"Comment on: use of thrombopoietin receptor agonist (romiplostim) in neonatal autoimmune thrombocytopenia due to maternal immune thrombocytopenia","volume":"66","author":"U Mahat","year":"2019","journal-title":"Pediatr Blood Cancer"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"3","DOI":"10.51362\/neonatology.today\/2021316337","article-title":"Romiplostim administration to a preterm neonate with severe prolonged acquired thrombocytopenia","volume":"16","author":"M D Kamitsuka","year":"2021","journal-title":"Neonatol Today"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2073-3848.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T08:50:53Z","timestamp":1730796653000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2073-3848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,13]]},"references-count":25,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2073-3848","archive":["Portico","CLOCKSS"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.742611348.793598436","asserted-by":"object"}]},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,4,13]]},"published":{"date-parts":[[2023,4,13]]}}}