Platelet transfusion

Question 1

Thresholds for platelet transfusion

Answer 1

Neurosurgery<100 x 109/L

Invasive procedures<50 x 109/L

Vaginal or caesarean birth <50 x 109/L

(CVC) insertion (elective)
<20 x 109/L

Critically ill patients<20 x 109/L

Chemotherapy or haematopoietic stem cell therapy (HSCT) with risk factors [a] <20 x 109/L

Chemotherapy or haematopoietic stem cell therapy (HSCT) without risk factors <10 x 109/L

All others- <10

*spontaneous bleeding can occur within a few platelet counts <10

*from Life Blood

Question 2

• Clinical Practice Notes:

Answer 2

• No clear evidence-base on thresholds; recommendations are clinician-guided.
• Platelet count does not always correlate with function or clotting ability.
• There’s no simple test for platelet function, though TEG (Thromboelastography) may help detect dysfunction.
• Transfusion decisions should be individualized based on the clinical scenario, not just platelet count.

From evidence based practice download