Supporting the platelet transfusion needs of refractory patients is very resource intensive. These patients present numerous challenges for all clinical providers, including pathologists, because they typically have multiple comorbidities, are receiving multiple medications, and given the low platelet count, are at risk for bleeding. Because of the suboptimal response to platelets, these patients typically receive more transfusions compared to non-refractory patients, according to Dr. Monica Pagano, Medical Director of the Transfusion Service Laboratory at UW Medical Center in Seattle, in this CAPcast. Dr. Pagano lead the development of a case-based course on this topic as part of the CAP’s Clinical Pathology Improvement Program—or CPIP (https://capatholo.gy/2X6gb0b).