Recommendation for a new transfusion threshold in pediatric platelet transfusion: Platelet mass measurement

The decision for platelet transfusion in children and newborns is associated with etiology of thrombocytopenia and concomitant comorbid conditions. In recent years, it has been shown that transfusion may be appropriate in newborn cases using platelet mass thresholds obtained by multiplying mean platelet volume (MPV) and platelet count. A number of 183 platelet transfusion administered to 82 patient aged 0-18 years between January 2017 and January 2019 at Başkent University Ankara Hospital were evaluated in our study in terms of transfusion threshold values, transfusion type and efficacy. It was observed that among platelet transfusions, 94 % were prophylactic and 6 % were therapeutic.There was no difference between the appropriateness of transfusion according to platelet mass and the prevention of bleeding and cost (p > 0.05).The number of transfusions that did not meet the platelet mass threshold value was 32 (17.7 %).Considering that conventional platelet transfusion threshold in pediatric cases is lower than in newborn cases (defined as 0-≤30 day old babies), we think that platelet mass threshold values similar to newborns can be used effectively in pediatric cases as well. The transfusion threshold values in our hypothesis may reduce morbidity and cost without reducing its effectiveness.