The Perl HL7 Toolkit should work on any platform on which Perl 5 runs.

Standard Perl installation works on many platforms, but the Net::HL7 API is pure Perl, so you can install it even if your platform doesn't have make or a C compiler.

Though most of the development has been on Linux/Unix OSes, hl7d has been tested and seem stable and fast on at least these platforms: Logo The HL7 Toolkit is hosted by SourceForge.