Preoperative Platelet Transfusion: Outcomes vs Guideline Thresholds
José Antonio García Erce, Director of the Donation Center, Navarre Health Service (Osasunbidea), shared on LinkedIn:
”Preoperative platelet transfusion in cancer surgery: Outcomes across and above guideline thresholds.
Preoperative platelet transfusion was associated with increased postoperative morbidity and mortality in a 8,800 patients surgical oncology cohort!
Importante trabajo multicéntrico, presentado el pasado día 7 en Orlando en el 67th Congreso de la American Society of Hematology, en uno de los Simposium de Transfusion, bajo el elegante título de Blood Transfusion: Transfusion Frontlines: “Research Driving Safer, Smarter Care” (¡qué bueno e importante título).
Los resultados refuerzan la necesidad de un PBM que incluya las plaquetas. La optimización de los pacientes no sólo es de la cifra de hemoglobina, de la hashtag#coagulación, o de la tolerancia a la anemia, también debemos tratar la trombocitopenia y la trombocitopatía, pero sin necesidad de transfusiones
The authors performed a retrospective, multicenter cohort study of 8,805 adults with active malignancy undergoing surgery under anesthesia from January 1, 2010, to January 1, 2025.
Results: After matching, 3,192 patients in each <50 × 10⁹/L group and 5,613 in each 50–100 × 10⁹/L group were analyzed. In the <50 × 10⁹/L stratum, preoperative platelet transfusion was associated with higher 30-day mortality compared with no transfusion (16.4% vs 11.7%, p<0.001).
– Transfused patients had greater ICU admission rates (12.0% vs 8.7%, p<0.001), more cerebral infarctions (3.9% vs 2.6%) and myocardial infarctions (3.3% vs 2.1%), and substantially more acute kidney failure (24.9% vs 16.8%, p<0.001).
– The likelihood of receiving additional platelet transfusions within 1–3 days postoperatively was markedly higher among transfused patients (27.0% vs 5.1%).
Conclusions: In this large, propensity-matched surgical oncology cohort, preoperative platelet transfusion was associated with increased postoperative morbidity and mortality both below and above current guideline thresholds…”
Read the full abstract here.
Title: Preoperative platelet transfusion in cancer surgery: Outcomes across and above guideline thresholds
Authors: Fatma Yilmaz, Jake Fanizza, Salih Akgun, Abdullah Aktas, Zeynep Yilmaz, Bugra Zengin, Medina Esenbekova, Anna Homeniuk, Anas Atras
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