{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:18:48Z","timestamp":1793146728474,"version":"4.5.0"},"reference-count":70,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2025,8,19]]},"abstract":"\n Importance<\/jats:title>\n Platelet transfusion is a frequent procedure with benefits and risks.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To provide recommendations in adult and pediatric populations in whom platelet transfusions are commonly performed.<\/jats:p>\n <\/jats:sec>\n \n Evidence Review<\/jats:title>\n Grading of Recommendations Assessment Development and Evaluation (GRADE) methodology was applied to findings from 21 randomized trials and 13 observational studies in contexts of limited randomized clinical trial data. Transfusion strategies using fewer (restrictive) vs greater (liberal) amounts of platelets were compared.<\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n \n Evidence demonstrated that restrictive transfusion strategies probably did not cause increases in mortality or bleeding relative to liberal strategies across predefined clinical populations. Exceedingly low incidence of spinal hematoma was identified in patients with thrombocytopenia undergoing lumbar puncture. Because definitions of restrictive strategies varied across trials, recommendations reflect practical guidance. The following recommendations are strong recommendations with high\/moderate\u2013certainty evidence. For hypoproliferative thrombocytopenia in nonbleeding patients receiving chemotherapy or undergoing allogeneic stem cell transplant, platelet transfusion is recommended when platelet count is less than 10\u2009\u00d7\u200910\n 3<\/jats:sup>\n \/\u03bcL. For consumptive thrombocytopenia in neonates without major bleeding, platelet transfusion is recommended when platelet count is less than 25\u2009\u00d7\u200910\n 3<\/jats:sup>\n \/\u03bcL. In patients undergoing lumbar puncture, platelet transfusion is recommended when platelet count is less than 20\u2009\u00d7\u200910\n 3<\/jats:sup>\n \/\u03bcL. In patients with consumptive thrombocytopenia due to Dengue without major bleeding, platelet transfusion is not recommended. The following recommendations are conditional recommendations with low\/very low\u2013certainty evidence. For hypoproliferative thrombocytopenia in nonbleeding adults undergoing autologous stem cell transplant or with aplastic anemia, prophylactic platelet transfusion is not recommended. In adults with consumptive thrombocytopenia without major bleeding, platelet transfusion is recommended when platelet count is less than 10\u2009\u00d7\u200910\n 3<\/jats:sup>\n \/\u03bcL. In adults undergoing central venous catheter placement in compressible anatomic sites, platelet transfusion is recommended when platelet count is less than 10\u2009\u00d7\u200910\n 3<\/jats:sup>\n \/\u03bcL. In adults undergoing interventional radiology, platelet transfusion is recommended when platelet count is less than 20\u2009\u00d7\u200910\n 3<\/jats:sup>\n \/\u03bcL for low-risk procedures and less than 50\u2009\u00d7\u200910\n 3<\/jats:sup>\n \/\u03bcL for high-risk procedures. For adults undergoing major nonneuraxial surgery, platelet transfusion is recommended when platelet count is less than 50\u2009\u00d7\u200910\n 3<\/jats:sup>\n \/\u03bcL. For patients without thrombocytopenia undergoing cardiovascular surgery in the absence of major hemorrhage, including those receiving cardiopulmonary bypass, platelet transfusion is not recommended. For nonoperative intracranial hemorrhage in adults with platelet count greater than 100\u2009\u00d7\u200910\n 3<\/jats:sup>\n \/\u03bcL, including those receiving antiplatelet agents, platelet transfusion is not recommended.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions And Relevance<\/jats:title>\n A consistent pattern of evidence supports the implementation of restrictive platelet transfusion strategies. Restrictive strategies reduce risk of adverse reactions, mitigate platelet shortages, and reduce costs. It is good practice to consider overall clinical context and alternative therapies in the decision to perform platelet transfusion.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2025.7529","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T13:30:16Z","timestamp":1748525416000},"page":"606","source":"Crossref","is-referenced-by-count":135,"title":["Platelet Transfusion"],"prefix":"10.1001","volume":"334","author":[{"given":"Ryan A.","family":"Metcalf","sequence":"first","affiliation":[{"name":"Department of Pathology, University of Utah, Salt Lake City"},{"name":"ARUP Laboratories, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Nahirniak","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, 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Immunol"},{"issue":"2","key":"jsc250006r58","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1213\/ANE.0000000000002794","article-title":"Prophylactic platelet transfusions for critically ill patients with thrombocytopenia: a single-institution propensity-matched cohort study.","volume":"128","author":"Warner","year":"2019","journal-title":"Anesth Analg"},{"key":"jsc250006r59","article-title":"Platelet transfusion in patients with sepsis and thrombocytopenia: a propensity score-matched analysis using a large ICU database.","volume":"9","author":"He","year":"2022","journal-title":"Front Med (Lausanne)"},{"issue":"4","key":"jsc250006r60","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1111\/trf.13996","article-title":"Preprocedural platelet transfusion for thrombocytopenic patients undergoing interventional radiology procedures is not associated with reduced bleeding complications.","volume":"57","author":"Warner","year":"2017","journal-title":"Transfusion"},{"issue":"5","key":"jsc250006r61","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/S0003-4975(10)60755-2","article-title":"Controlled trial of routine administration of platelet concentrates in cardiopulmonary bypass surgery.","volume":"37","author":"Simon","year":"1984","journal-title":"Ann Thorac Surg"},{"issue":"2","key":"jsc250006r62","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.athoracsur.2020.04.139","article-title":"Platelet transfusion in cardiac surgery: a systematic review and meta-analysis.","volume":"111","author":"Yanagawa","year":"2021","journal-title":"Ann Thorac Surg"},{"issue":"6","key":"jsc250006r63","doi-asserted-by":"crossref","first-page":"740","DOI":"10.3324\/haematol.2014.118075","article-title":"Risk of bleeding and use of platelet transfusions in patients with hematologic malignancies: recurrent event analysis.","volume":"100","author":"Stanworth","year":"2015","journal-title":"Haematologica"},{"issue":"8","key":"jsc250006r64","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1016\/j.jvir.2019.04.017","article-title":"Society of Interventional Radiology consensus guidelines for the periprocedural management of thrombotic and bleeding risk in patients undergoing percutaneous image-guided interventions: part II: recommendations endorsed by the Canadian Association for Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe.","volume":"30","author":"Patel","year":"2019","journal-title":"J Vasc Interv Radiol"},{"issue":"26","key":"jsc250006r66","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1182\/blood.2019000899","article-title":"Preterm neonates benefit from low prophylactic platelet transfusion threshold despite varying risk of bleeding or death.","volume":"134","author":"Fustolo-Gunnink","year":"2019","journal-title":"Blood"},{"issue":"5","key":"jsc250006r69","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1111\/tme.12994","article-title":"The ongoing dilemma of prophylactic platelet transfusions pre-procedure and the development of evidence-based recommendations.","volume":"33","author":"Stanworth","year":"2023","journal-title":"Transfus Med"},{"issue":"18","key":"jsc250006r70","doi-asserted-by":"crossref","first-page":"E839","DOI":"10.1503\/cmaj.090449","article-title":"AGREE II: advancing guideline development, reporting and evaluation in health care.","volume":"182","author":"Brouwers","year":"2010","journal-title":"CMAJ"},{"key":"jsc250006r11","volume-title":"Technical Manual, 21st Edition"},{"key":"jsc250006r36","doi-asserted-by":"crossref","DOI":"10.17226\/13058","volume-title":"Clinical Practice Guidelines We Can Trust","author":"Graham","year":"2011"},{"key":"jsc250006r5","unstructured":"Serious Hazards of Transfusion. SHOT annual reports and summaries. Accessed August 16, 2024. https:\/\/www.shotuk.org\/shot-reports\/"},{"key":"jsc250006r6","unstructured":"Narayan? DS, Baker? DP, Bellamy? PM, . Annual 2023 SHOT report. Accessed May 12, 2025. https:\/\/www.shotuk.org\/shot-reports\/annual-shot-report-2023\/"},{"key":"jsc250006r45","unstructured":"RevMan: systematic review and meta-analysis tool for researchers worldwide. Cochrane RevMan. Accessed May 29, 2024. https:\/\/revman.cochrane.org\/info"},{"key":"jsc250006r65","doi-asserted-by":"crossref","unstructured":"Lee-Miller? C, Kairalla JA, Hibbitts E, et al. Additional induction intrathecal cytarabine for patients with CNS2 disease at diagnosis is not beneficial for patients with B-ALL treated on Children\u2019s Oncology Group Protocols AALL0932 and AALL1131. Presented at Annual Society of Hematology Annual Meeting and Exposition; December 9, 2024. 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