Platelet transfusion

Guidelines

The following summarized guidelines for the management of platelet transfusion are prepared by our editorial team based on guidelines from the European Society of Intensive Care Medicine (ESICM 2020) and the American Association of Blood Banks (AABB 2015).

1. Medical management

Indications for platelet transfusion

Transfuse platelets prophylactically to reduce the risk for spontaneous bleeding in hospitalized adult patients with therapy-induced hypoproliferative thrombocytopenia.
Transfuse platelets prophylactically to hospitalized adult patients with a platelet count ≤ 10×109 cells/L to reduce the risk for spontaneous bleeding.

2. Specific circumstances

Patients undergoing cardiopulmonary bypass

Avoid routine prophylactic platelet transfusion for patients who are not thrombocytopenic undergoing cardiac surgery with cardiopulmonary bypass.
Consider platelet transfusion for patients undergoing cardiopulmonary bypass who exhibit perioperative bleeding with thrombocytopenia and/or evidence of platelet dysfunction.

Critically ill patients, non-bleeding

avoid administering platelet transfusion to treat thrombocytopenia unless the platelet count falls < 10×109/L.

References

1.Kaufman RM, Djulbegovic B, Gernsheimer T et al. Platelet transfusion: a clinical practice guideline from the AABB. Ann Intern Med. 2015 Feb 3;162 3 :205-13.

2.Alexander P Vlaar, Simon Oczkowski, Sanne de Bruin et al. Transfusion strategies in non-bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine. Intensive Care Med. 2020 Apr;46 4 :673-696.

3.Schiffer CA, Bohlke K, Delaney M et al. Platelet Transfusion for Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2018 Jan 20;36 3 :283- 299.

4.Alexander P J Vlaar, Joanna C Dionne, Sanne de Bruin et al. Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine. Intensive Care Med. 2021 Dec;47 12 :1368-1392.

5.Charles A Schiffer, Kari Bohlke, Meghan Delaney et al. Platelet Transfusion for Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2018 Jan 20;36 3 :283-299.