{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:12:42Z","timestamp":1791403962131,"version":"4.3.3"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thrombotic thrombocytopenic purpura (TTP) is a life\u2010threatening thrombotic microangiopathy caused by severe ADAMTS13 deficiency. Platelet transfusions are generally contraindicated but are often administered before TTP is recognized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the association between platelet transfusion in the emergency department (ED) and outcomes in laboratory\u2010confirmed TTP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective multicenter cohort study using the TriNetX Research Network (2014\u20132025). Adults presenting to the ED with ADAMTS13 activity &lt;\u200910% who received plasma exchange within 48\u2009h were included. The exposure was platelet transfusion within 24\u2009h. The primary outcome was 30\u2010day all\u2010cause mortality; secondary outcomes included myocardial infarction (MI), stroke, intracranial hemorrhage, thrombosis, and ICU\u2010level care. Propensity score matching (1:1) and Cox modeling were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 693 patients, 99 (13.9%) received platelet transfusion. After matching, platelet transfusion was associated with higher 30\u2010day mortality (30.0% vs. 13.3%; OR 2.79, 95% CI 1.31\u20135.93;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) and increased MI. In Cox analysis, platelet transfusion remained independently associated with mortality (adjusted HR 2.45, 95% CI 1.24\u20134.85).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In confirmed TTP, early platelet transfusion was independently associated with increased short\u2010term mortality, supporting recommendations to avoid platelet transfusion and emphasizing early recognition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ejh.70277","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:48:03Z","timestamp":1785113283000},"page":"1327-1337","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Platelet Transfusion in Patients With Low\n                    <scp>ADAMTS13<\/scp>\n                    \u2010Confirmed Thrombotic Thrombocytopenic Purpura Is Associated With Increased Mortality"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9905-7139","authenticated-orcid":false,"given":"Joseph","family":"O'Brien","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Denver Health Medical Center  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3884-6234","authenticated-orcid":false,"given":"Alvin H.","family":"Schmaier","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology\/Oncology University Hospitals Cleveland Medical Center  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayher J.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Colorado, Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3641-6265","authenticated-orcid":false,"given":"Michael","family":"Daunov","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology\/Oncology University Hospitals Cleveland Medical Center  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leland","family":"Metheny","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology\/Oncology University Hospitals Cleveland Medical Center  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology\/Oncology University Hospitals Cleveland Medical Center  Cleveland Ohio 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