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Shiny K. Kajal: Platelet Transfusion Is a Clinical Decision, Not a Reflex

Shiny K. Kajal/LinkedIn

Apr 4, 2026, 16:11

Shiny K. Kajal: Platelet Transfusion Is a Clinical Decision, Not a Reflex

Shiny K. Kajal, Senior Resident at Adesh University, shared a post on Linkedin:

“Post 39- Platelet transfusion is not a reflex. It’s a clinical decision.

We continue to see platelet requests based purely on numbers-without bleeding, without procedures, without indication.

Let’s pause and realign with evidence-based practice:

A platelet count of 50,000/uL in a stable, non-bleeding patient does not warrant transfusion.
Prophylactic transfusion is typically reserved for counts ≤10,000/uL to prevent spontaneous hemorrhage.
In active bleeding or before invasive procedures, transfusion decisions must be guided by clinical context, not just lab values.
Higher thresholds are justified only in specific settings like neurosurgery or ocular procedures.

Unnecessary transfusions are not benign — they expose patients to risks including:
Transfusion reactions, alloimmunization, infections, and resource misuse.

More is not better in transfusion medicine. Appropriate is.

It’s time we move away from ‘treating the number’ and return to what truly matters — treating the patient.”

Shiny K. Kajal