Prophylactic platelet transfusions: why less is more

Abstract

In short, given the current evidence base, we recommend the use of restrictive platelet transfusion thresholds while awaiting the results of new/ongoing studies and large-scale epidemiologic studies. Future trialists will have an opportunity to address the identified challenges and additionally improve the efficiency and design of these trials using electronic patient data and advanced trial designs. There clearly is a need for new biomarkers and models to better predict bleeding risk for more tailored platelet transfusion decisions, implementation strategies to support evidence-based transfusion practices, and fundamental research to better understand the mechanisms of transfusion-related harm.