{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T13:38:28Z","timestamp":1776260308377,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Evidence supports a restrictive platelet transfusion threshold in preterm neonates. We aimed to describe the effect of implementing this threshold on transfusion rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>This retrospective observational cohort study included all very preterm infants (born &lt;32\u2009weeks' gestation) admitted to a neonatal intensive care unit between 2004 and 2022, divided into three epochs. Platelet transfusion thresholds changed from 30\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L for stable neonates and 50\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L for unstable neonates (January 2004 to December 2009) to 20\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L for stable neonates and 50\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L for unstable neonates (January 2010 to June 2019) to 25\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L for non\u2010bleeding neonates and 50\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L for neonates with major bleeding (July 2019 to July 2022). The primary outcome was the percentage of transfused neonates in each epoch. Secondary outcomes included the median number of transfusions per neonate, the percentage of transfusions given above 25 or 50\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L, and major bleeding and mortality rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The percentage of neonates transfused was 12.2% (115\/939), 5.8% (96\/1660), and 4.8% (25\/525) in Epoch I, II, and III, respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), a relative reduction of 61%. The median number of transfusions per transfused neonate was 2.0 (interquartile range [IQR]: 1.0\u20133.0) in Epoch I, and 1.0 (IQR: 1.0\u20132.0) in subsequent Epochs (<jats:italic>p<\/jats:italic>\u2009=\u2009.04). The percentage of infants receiving at least one transfusion above 50\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L in Epoch I, II, and III was 51.3% (59\/115), 17.7% (17\/96), and 20.0% (5\/25; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Mortality and bleeding rates did not significantly differ between epochs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Implementation of restrictive platelet guidelines led to reduction of the rate and number of platelet transfusions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17844","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T09:48:23Z","timestamp":1714038503000},"page":"1421-1427","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of restrictive platelet transfusion strategies on transfusion rates: A cohort study in very preterm infants"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-8991","authenticated-orcid":false,"given":"L. E.","family":"Heeger","sequence":"first","affiliation":[{"name":"Willem\u2010Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology Leiden University Medical Center  Leiden The Netherlands"},{"name":"Sanquin Blood Supply Foundation Clinical Center for Transfusion Research  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. A. M.","family":"Houben","sequence":"additional","affiliation":[{"name":"Willem\u2010Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology Leiden University Medical Center  Leiden The Netherlands"},{"name":"Sanquin Blood Supply Foundation Clinical Center for Transfusion Research  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Caram\u2010Deelder","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. F.","family":"Fustolo\u2010Gunnink","sequence":"additional","affiliation":[{"name":"Sanquin Blood Supply Foundation Clinical Center for Transfusion Research  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. G.","family":"van der Bom","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Lopriore","sequence":"additional","affiliation":[{"name":"Willem\u2010Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2021.04.002"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1807320"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2016.05.009"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.0507"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019000899"},{"issue":"5","key":"e_1_2_9_7_1","first-page":"452","article-title":"Two\u2010year outcomes following a randomised platelet transfusion trial in preterm infants","volume":"108","author":"Moore CM","year":"2023","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"e_1_2_9_8_1","first-page":"1","volume-title":"Richtlijn bloedtransfusie","author":"CBO","year":"2011"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-021-01033-6"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2012.01658.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17184"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2023.03.003"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14233"},{"key":"e_1_2_9_14_1","volume-title":"National Blood Authority Australia guideline: Patient Blood Management guidelines: module 6 neonatal and paediatrics","author":"NBA"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197802022980519"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(78)80282-0"},{"issue":"2701","key":"e_1_2_9_17_1","first-page":"1","article-title":"Richtlijn Perinataal beleid bij extreme vroeggeboorte","volume":"154","author":"Laat MWM","year":"2010","journal-title":"Ned Tijdschr Geneeskd"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12127"},{"key":"e_1_2_9_19_1","first-page":"258","volume-title":"Transfusieproduct trombocytentransfusies neonaten trombocytopenie. 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