How I do it: platelet support for refractory patients

All of us have encountered patients for whom platelet (PLT) transfusions fail to result in an adequate increment. These patients can be difficult to support and the best approach to their care is not clear—nor is any single strategy preferred. 1 This summary, which would more properly be entitled how “we” do it (for this is surely a collaborative effort), describes the approach taken at Massachusetts General Hospital in Boston. Our blood transfusion service has it own donor program and an in-house HLA laboratory, but also relies heavily on the support of the American Red Cross, Northeast Region, which maintains a database of HLA-typed donors.