March 3, 2026Open Access

Platelet Transfusion Practices and Outcomes in Neonates and Children

Key Points

Lower posttransfusion platelet increments occur with older male donors and longer storage duration—showing a need for practice reassessment.
Overall platelet transfusion burden increases with prolonged storage or use of PAS and PR products; guidelines need to reflect these findings.
Cohort study linking donor and recipient data illustrates the complexity of transfusion outcomes and practices.
Further well-designed prospective studies are necessary to validate these implications for clinical practice.

Abstract

In this multicenter, donor-product-recipient linked cohort study, after excluding patients with bleeding, most transfusions among neonates and older children were at high pretransfusion platelet counts. Use of PAS, PR, longer storage duration, male donors, and donor age older than 40 years were independently associated with lower posttransfusion platelet increments. Use of PAS, PR, platelet storage longer than 3 days, and donor age 40 years or older were associated with a significantly higher overall platelet transfusion burden but were not associated with hospital length of stay or mortality. These results have important implications for transfusion practices for platelets among neonates and children and need validation in well-designed prospective studies.

Platelet Transfusion Practices and Outcomes in Neonates and Children

Key Points

Abstract

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