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2025 Platelet Transfusion Thresholds: When to Transfuse and When Not to Transfuse – Chokri Ben Lamine
Jul 30, 2026, 15:16

2025 Platelet Transfusion Thresholds: When to Transfuse and When Not to Transfuse – Chokri Ben Lamine

Chokri Ben Lamine, Assistant Consultant at King Faisal Specialist Hospital and Research Center, shared a post on X about a recent article by Ryan A. Metcalf et al., published in JAMA, adding:

”2025 AABB/ICTMG Platelet Transfusion Thresholds

Nonbleeding chemotherapy / allo-HSCT: transfuse if platelet count is less than 10 × 10⁹/L

Adult critical illness, no major bleeding: transfuse if platelet count is less than 10 × 10⁹/L

Lumbar puncture: transfuse if platelet count is less than 20 × 10⁹/L

CVC insertion at compressible site (IJ/femoral): transfuse if platelet count is less than 10 × 10⁹/L

Interventional radiology:

  • Low-risk procedure: transfuse if platelet count is less than 20 × 10⁹/L
  • High-risk procedure: transfuse if platelet count is less than 50 × 10⁹/L
  • Major non-neuraxial surgery: transfuse if platelet count is less than 50 × 10⁹/L
  • Preterm neonate without major bleeding: transfuse if platelet count is less than 25 × 10⁹/L

Autologous SCT or aplastic anemia, nonbleeding adults: routine prophylactic transfusion not recommended

Dengue without major bleeding: platelet transfusion not recommended

Nonoperative ICH with platelet count greater than 100 × 10⁹/L, including antiplatelet use: platelet transfusion is not recommended.

Central-line removal is not specifically addressed; the threshold of less than 10 × 10⁹/L applies to insertion at compressible sites, not to removal.

Clinical bleeding, coagulopathy, medications, catheter site/type, and ability to apply compression should guide removal.

Platelet Transfusion – JAMA 2025.pdf. ”

Title: 2025 AABB and ICTMG International Clinical Practice Guidelines

Authors:Ryan A. Metcalf, Susan Nahirniak, Gordon Guyatt, Aarti Bathla, Sandra K. White, Arwa Z. Al-Riyami, Rachel C. Jug, Ursula La Rocca, Jeannie L. Callum, Claudia S. Cohn, Abe DeAnda, Robert A. DeSimone, Allan Dubon, Lise J. Estcourt, Daniela C. Filipescu, Mark K. Fung, Ruchika Goel, Aaron S. Hess, Heather A. Hume, Richard M. Kaufman, Peter Kranke, Vernon J. Louw, Morten H. Møller, Michael F. Murphy, Jennifer A. Muszynski, Cian J. O’Kelly, Monica B. Pagano, Gopal K. Patidar, Katerina Pavenski, Jacqueline N. Poston, Nabiha H. Saifee, Moritz Stolla, Zbigniew M. Szczepiorkowski, Aaron A. R. Tobian, Raman Uberoi, Jonathan Waters, Brittney Williams, Erica M. Wood, Nicole D. Zantek, Michelle P. Zeller, Brenda J. Grossman, Simon J. Stanworth.

2025 Platelet Transfusion Thresholds: When to Transfuse and When Not to Transfuse - Chokri Ben Lamine

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Aaron A.R. Tobian Aaron S. Hess Aarti Bathla Abe DeAnda Allan Dubon Arwa Z. Al-Riyami Brenda J. Grossman Brittney Williams Chokri Ben Lamine Cian J. O’Kelly Claudia S. Cohn Daniela C. Filipescu Erica M Wood Gopal K. Patidar Gordon Guyatt Health Heather A. Hume Hematology Hemostasis Hemostasis News Hemostasis Today Jacqueline N. Poston Jeannie L. Callum Jennifer A. Muszynski Jonathan Waters Katerina Pavenski Lise J. Estcourt Mark K. Fung Medicine Michael F. Murphy Michelle P. Zeller Monica B. Pagano Moritz Stolla Morten H. Møller Nabiha H. Saifee Nicole D. Zantek Peter Kranke Rachel C. Jug Raman Uberoi Richard M. Kaufman Robert A. DeSimone Ruchika Goel Ryan A. Metcalf Sandra K. White Simon J. Stanworth Susan Nahirniak Ursula La Rocca Vernon J. Louw Zbigniew M. Szczepiorkowski
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