[Evidence-based and practical: scrutiny of the new guidelines on platelet transfusion]

The transfusion of platelet concentrates is an established treatment for thrombocytopenia or platelet dysfunction. The new international guideline from the Association for the Advancement of Blood and Biotherapies in collaboration with the International Collaboration for Transfusion Medicine Guidelines is based on 21 randomized and 13 observational studies comparing restrictive and liberal transfusion strategies. The evidence shows that restrictive strategies do not significantly increase 30-day mortality or the risk of severe bleeding (WHO grade 3-4), but are associated with a lower rate of transfusion-associated adverse events, improved resource availability, and lower costs. The guideline supports restrictive transfusion strategies, but emphasizes the need for individual clinical decisions taking into account symptoms, comorbidities, and patient preferences.