Platelet Transfusion

作者：Ryan A. Metcalf, Susan Nahirniak, Gordon Henry Guyatt, Aarti Bathla, Sandra White, Arwa Z. Al‐Riyami, Rachel C. Jug, Ursula La Rocca, Jeannie L. Callum, Claudia S. Cohn, Abe DeAnda, Robert Andrew Desimone, Allan Dubon, Lise J Estcourt, Daniela Carmen Filipescu, Mark K.Y. Fung, Ruchika Goel, Aaron Stansbury Hess, Heather Ann Hume, Richard Max Kaufman, Peter Kranke, Vernon Johan Louw, Morten Hylander Møller, Michael F. Murphy, Jennifer A. Muszynski, Cian O′Kelly, Monica B. Pagano, Gopal Kumar Patidar, Katerina Pavenski, Jacqueline N. Poston, Nabiha H. Saifee, Moritz Stolla, Zbigniew M. Szczepiorkowski, Aaron A.R. Tobian, Raman Uberoi, Jonathan H. Waters, Brittney Williams, Erica M. Wood, Nicole D. Zantek, Michelle P. Zeller, Brenda J. Grossman, Simon J. Stanworth · 发表于：JAMA · 年份：2025 · DOI：10.1001/jama.2025.7529 · 被引用次数：114 · 研究领域：Blood transfusion and management、Platelet Disorders and Treatments、Hematopoietic Stem Cell Transplantation

Importance: Platelet transfusion is a frequent procedure with benefits and risks. Objective: To provide recommendations in adult and pediatric populations in whom platelet transfusions are commonly performed. Evidence Review: 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. Findings: 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-certainty 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 × 103/μL. For consumptive thrombocytopenia in neonates without major bleeding, platelet transfusion is recommended when platelet count is less than 25 × 103/μL. In patients undergoing lumbar puncture, platelet tra...