Factors associated with refractoriness to platelet transfusion

Non-immune

Fever, sepsis, or infection

Splenomegaly

DIC

Bleeding

Medications, especially amphotericin and heparin

Hematopoietic stem cell transplant

Alloimmune

Anti-HLA antibodies (typically anti-HLA-A and anti-HLA-B)

Anti-HPA antibodies

Refer to UpToDate for additional discussion of the mechanisms of platelet refractoriness and patient evaluation and management.

DIC: disseminated intravascular coagulation; HLA: human leukocyte antigen; HPA: human platelet antigen.

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