Platelet transfusion

Platelet (PLT) biology is deceptively complicated. From a morphological aspect, the elegant discoid shape of the resting platelet belies the intricate cytoskeleton and convoluted tubular systems that enable spectacular shape change upon activation. The evolution of platelet products and their use in transfusion is similarly convoluted and requires immersion in history to understand. As described below, the current state of the art in platelet transfusion rests on surprisingly little robust clinical data, minimal efforts to tailor product characteristics to patient needs, and a regulatory framework that does not facilitate optimizing platelet function. Development of new platelet products and optimal transfusion strategies for bleeding patients represent opportunities for major advances in the care of bleeding patients or those at high risk of bleeding.