Platelet Transfusion 2025 Guideline Update (Critical care, AABB, ITCMG)
Fewer platelet transfusions, please, say societies. Show us the RCTs
A second 2025 professional guideline document advises a restrictive transfusion strategy for most patients with thrombocytopenia.
The 2025 guidance comes from the American Association for Blood and Biotherapies (AABB, f.k.a. the American Association of Blood Banks), which teamed with the International Collaboration for Transfusion Medicine Guidelines (ICTMG) to produce a thankfully brief document published in JAMA.
It comes close on the heels of the U.S. “chest medicine” / critical care society’s 2025 guidance document, which also advised withholding prophylactic platelet transfusions in most patients. We reviewed that here:
Guideline review: Transfusing fresh frozen plasma and platelets in critical illness
Coagulation abnormalities (e.g., an elevated international normalized ratio or INR) and thrombocytopenia are present in most severely ill patients.
The “chest” society is led by critical care physicians, mostly pulmonary/critical care. The AABB is controlled by pathologists who manage blood banks, but who enlist critical care physicians to help write the guidelines.
Let’s see where they agree, and don’t.
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