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PLASTIC RECONSTRUCTIVE AND REGENERATIVE SURGERY

Abstract

Background - The aim of this analysis was to evaluate the impact of different platelet transfusion thresholds on short-term and long-term outcomes in preterm infants, and to inform evidence-based, individualized transfusion strategies.

Materials and methods - PubMed, Embase, and the Cochrane Library (database initiation until December 2024) were searched. Comparative studies of restrictive transfusion strategies vs liberal transfusion strategies in thrombocytopenic neonates were included. The review protocol was prospectively registered (CRD42020169262).

Results - Of 4,102 reports screened, three randomized controlled trials and two cohort studies were included (1,851 patients). Restrictive transfusion strategies did not increase short-term adverse events and may potentially reduce the incidence of mortality and severe neurodevelopmental impairment at 2 years corrected age.

Discussion - Restrictive platelet transfusion thresholds (25×10⁹/L, or even 20×10⁹/L) appear to be safe and may improve long-term prognosis. These findings support a shift toward more individualized, evidence-based transfusion practices in neonatal care.

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Authors

Dengjun Liu - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China

Qian Gao - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China

Jogender Kumar - Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India https://orcid.org/0000-0002-0464-9689

Yan Yue - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China

Jing Shi - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China https://orcid.org/0000-0003-0835-8587

Jun Tang - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China

Tao Xiong - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China https://orcid.org/0000-0002-0408-1288

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