Continuing Education Episode!
Continuing Education!
What if everything we THOUGHT we knew about neonatal platelet transfusion is wrong?
Dr. Martha Sola-Visner
Neonates are one of the most heavily transfused populations in the hospital. In fact, the more premature the baby, the more likely that neonate will have thrombocytopenia. A low platelet count makes it more likely that neonate will bleed into his/her head (i.e., intracranial hemorrhage), with potentially disastrous results. For decades, our response to this problem has been simple: Give the baby platelets! But what if that’s NOT the right answer? A recent large trial on neonatal platelet transfusion was published in the New England Journal of Medicine in early 2019 (co-authors Anna Curley and Simon Stanworth and group; see reference below). This study, known as “PlaNet-2,” should make us all question old ideas about when neonates need platelet transfusion. My guest on this episode, Dr. Martha Sola-Visner, has made studying the effect of “adult” platelet transfusions on neonates the focus of much of her extensive research as a neonatologist. Martha is here to explain key takeaways from PlaNet-2, and discuss where we need to go next. Get ready to have some assumptions challenged!
Dr. Martha Sola-Visner
Neonates are one of the most heavily transfused populations in the hospital. In fact, the more premature the baby, the more likely that neonate will have thrombocytopenia. A low platelet count makes it more likely that neonate will bleed into his/her head (i.e., intracranial hemorrhage), with potentially disastrous results. For decades, our response to this problem has been simple: Give the baby platelets! But what if that’s NOT the right answer? A recent large trial on neonatal platelet transfusion was published in the New England Journal of Medicine in early 2019 (co-authors Anna Curley and Simon Stanworth and group; see reference below). This study, known as “PlaNet-2,” should make us all question old ideas about when neonates need platelet transfusion. My guest on this episode, Dr. Martha Sola-Visner, has made studying the effect of “adult” platelet transfusions on neonates the focus of much of her extensive research as a neonatologist. Martha is here to explain key takeaways from PlaNet-2, and discuss where we need to go next. Get ready to have some assumptions challenged!
Download the Transcript for This Episode
About My Guest: Martha Sola-Visner, MD is an Associate Professor of Pediatrics at Harvard and Boston Children’s Hospital, and Director of Newborn Medicine Clinical Research at Boston Children’s Hospital. She is board-certified in Neonatal-Perinatal Medicine, and serves as an editorial board member for the journal JAMA Pediatrics.
Martha has spent her career focusing on studying neonatal hematologic disorders, with an emphasis on platelet disorders. Her laboratory has been responsible for breakthrough studies describing differences between adult and neonatal platelet production and lifespan, and her recent work has shed new light on the problems that can ensue when “adult” platelets are transfused to neonates.
Dr. Sola-Visner has authored or co-authored over 70 publications in peer-reviewed journals, and her research has been supported by numerous NIH/NHLBI grants throughout her career.
FREE Continuing Education! This podcast episode offers a FREE continuing education activity where you can earn the following types of credit: 1 AMA PRA Category 1 CreditTM, 1 ASCLS P.A.C.E.® Contact Hour (including Florida Clinical Laboratory Credit), and American Board of Pathology Self-Assessment Modules (SAMs) for Continuing Certification (CC, formerly MOC).
To receive credit and review the accreditation information and related disclosures, please visit Transfusion News Continuing Education on Wiley Health Learning.
Quick quiz:
DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone, and do not reflect those of the organizations with which either of us is affiliated. Neither Dr. Sola-Visner nor I have any relevant financial disclosures.
Further Reading: * PlaNet-2 Trial discussed in this interview: Curley A, Stanworth S et al. Randomized Trial of Platelet-Transfusion Thresholds in Neonates. N Engl J Med 2019;380:242-251 (journal access required). * Dr. Sola-Visner’s editorial accompanying PlaNet-2: Sola-Visner M. Platelet Transfusions in Neonates — Less Is More. N Engl J Med 2019;380:287-288 (journal access required). * Josephson CD et al. Platelet Transfusion Practices Among Neonatologists in the United States and Canada: Results of a Survey. Pediatrics 2009:123(1):278-285. * Cremer M et al. Platelet transfusions in neonates: practices in the United States vary significantly from those in Austria, Germany, and Switzerland. Transfusion 2011;51:2634-2641 (journal access required). * Sparger KA, et al. Platelet Transfusion Practices Among Very-Low-Birth-Weight Infants. JAMA Pediatr. 2016;170(7):687–694. * Stanworth SJ, et al. Prospective, Observational Study of Outcomes in Neonates With Severe Thrombocytopenia. Pediatrics 2009:124(5):e826-e834 (journal access required). * Patel RM et al. Platelet transfusions and mortality in necrotizing enterocolitis. Transfusion 2019;59(3):981-988 (journal access required).
Thanks to: * Dr. Daniela Hermelin, Assistant Editor; Please follow Daniela on Twitter for fantastic #blooducation! * Samantha Chaffin, Design and content consultant
Music Credit Music for this episode includes “Cuando te invade el temor” and “Reflejo,” both by Mar Virtual via the Free Music Archive. Click the image below for permissions and license details.
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