How to Order Platelet Transfusions for Refractory Patients

If you've got somebody who you give a platelet to and they get no response, it is not likely to be from an AVO incompatibility in my experience. If you have a high index of suspicion that you, your patient may have HLA antibodies or be refractory due to antibodies, the simplest thing to order is a test for HLA antibodies and an HLA type. You do not need a full typing like you would for a bone marrow transplant. However, since I work in a hospital with a large cancer center, they often end up needing special platelets. So we order them together.