Look at the difference in colour of these two platelet units… there’s an important reason why these two are so different but platelets do come in different colours, though they should be a variation of “straw”. Some will even look slightly green! #blooducation

So what special requirement does the patient need that is causing the colour difference here?

Some of you spotted that one of these units is irradiated, however that doesn’t affect the colour like washing! The unit on the left has been “washed”. This means the unit has had 100% plasma removed and replaced with sterile additive solution. Why might a pt need this?

Yes, washing is recommended in the @BritSocHaem guideline for use of platelet transfusions ( @AndelLestcourt et al. 2016) for the management of patients with severe allergic reactions https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.14423

However, washing platelets doesn’t come without drawbacks.

In addition to an increased cost it’s also a logistical challenge to arrange for washed platelets especially in acutely unwell patients where the decision to order them needs to be made a day before you know whether the patient will need them, esp as you can’t use another day.

The reason for this is that washed platelets need to be made to order and must be shipped via the local stock holding unit from either Bristol, North London or Manchester. They have a 24 hour shelf life from washing which also reduces the dose.

This means the decision to order washed platelets needs to be taken in conjunction with a Haematologist and involve good communication with the transfusion laboratory as to ongoing requirements in acutely unwell patients.

What if your patient is bleeding and needs platelets urgently? Here’s where communication between the clinical team laboratory, haematologist and even NHSBT is vital. It may be a decision to go for best available in a given circumstance and manage any reaction as and when...