PLATELET TRANSFUSION STRATEGIES IN SURGERY AND ANESTHESIA

Abstract

Importance:  Platelet transfusions are lifesaving in specific clinical contexts, particularly for patients with thrombocytopenia (low platelet counts) or platelet dysfunction. However, the procedure is not without risks. Platelets are biologically active and prone to cause immune and non-immune adverse events more frequently than red blood cell transfusions. 

Objective: To provide recommendations in adult and pediatric populations in whom platelet transfusions are commonly performed. 

Evidence Review: The new platelet transfusions guidelines established by the Association for the Advancement of Blood and Biotherapies (AABB) and the International Collaboration for Transfusion Medicine Guidelines (ICTMG), including Grading of Recommendations Assessment Development and Evaluation (GRADE) methodology were based on data of 21 randomized controlled trials and 13 observational studies  all of which examined transfusion strategies using restrictive or liberal amounts of platelets. The authors noted that overall evidence demonstrated that restrictive transfusion strategies were not associated with increased  risk of mortality, or increased bleeding, in most patient populations.