• M Lozano, A Mahon, P F van der Meer, S Stanworth, J Cid, D Devine, M K Fung, B de la Salle, N M Heddle, and Biomedical Excellence for Safer Transfusion (BEST) Collaborative.
• University Clinic Hospital, Barcelona, Spain.
• Vox Sang. 2014 May 1; 106 (4): 330-6.

Background And ObjectivesObtaining accurate and precise platelet enumeration in automatic platelet analysers at low platelet counts is a challenge. To explore the performance of current haematology analysers in counting platelet concentrations usually used as platelet transfusion threshold.Material And MethodsAn international exercise where four blood samples with platelet levels near usual platelet transfusion thresholds was prepared and distributed.ResultsThe samples shipped had a platelet count of 6·3, 13·3, 21·6 and 53·0 × 10(9) /l according to the international reference method. We received 82 sets of results from nine countries. Instruments from six different manufacturers were represented. Although the mean count for each of the four samples was very similar to the values, according to the reference method (9·0, 16·2, 23·0 and 57·6 × 10(9) /l), significant variability in the results was found. Assuming that these were patient samples and the result of the count used to indicate a prophylactic platelet transfusion, undertransfusion would have occurred for 24·5% of the LP1 samples at a transfusion threshold of 10 × 10(9) /l and, at a threshold of 20 × 10(9) /l, undertransfusion would have occurred for 7·2% of the LP1 and 16·2% of the LP2 samples and overtransfusion would have occurred with 23·1% of the LP3 samples.ConclusionThe results suggest that significant inaccuracy exists in counting low levels of platelets and that this inaccuracy might have a significant impact in under- and overtransfusion of platelet concentrates to patients.© 2013 International Society of Blood Transfusion.

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