Preoperative platelet transfusions: A retrospective review of pediatric patients with thrombocytopenia, 2011–2016

Jule Muegge, Tatiana de Warren, Daniel Saltzman, Donavon Hess

Research output: Contribution to journalArticlepeer-review


Background: Thrombocytopenia is a common perioperative clinical problem and preoperative platelet transfusion prior to surgery is standard practice. Recent platelet trials and literature reviews have found no association between platelet count and bleeding incidence except when platelet count is extremely low. Our aim was to evaluate the bleeding risk and the overall platelet transfusion management among pediatric patients with severe thrombocytopenia based on whether they were preoperatively transfused versus transfused at time of incision. Methods: This is a retrospective analysis of pediatric patients with a platelet count ≤50 × 109/L in the 12 h prior to surgery at a single tertiary pediatric hospital from 2011 to 2016. Eligible patients were ≤21 years old. Patients with necrotizing enterocolitis and neonates were excluded. The primary outcome was postoperative bleeding complications. Additional outcomes were preoperative platelet change and weight adjusted transfusion volumes. Results: A total of 37 patients were included in this analysis of which 29 (78%) received preoperative platelet transfusions within 12 h prior to surgery. No postoperative bleeding complications occurred 30 days after operation, regardless of preoperative transfusion status. There was no significant difference in platelet change by preoperative transfusion status and preoperative transfusion volume was a poor predictor of change in preoperative platelet count (crude: r2=0.19, age/gender adjusted: r2=0.48). Conclusion: Patients transfused at time of surgical procedure did not have an increased risk of bleeding over those preoperatively transfused. This finding is in agreement with previous studies in adult populations, supporting the safety of deferring platelet transfusions until the time of incision for thrombocytopenic pediatric surgical patients.

Original languageEnglish (US)
Pages (from-to)1657-1660
Number of pages4
JournalJournal of Pediatric Surgery
Issue number9
Early online dateMay 2 2021
StatePublished - Sep 2021

Bibliographical note

Publisher Copyright:
© 2021 Elsevier Inc.


  • Bleeding risk
  • Pediatrics
  • Platelet transfusion
  • Thrombocytopenia


Dive into the research topics of 'Preoperative platelet transfusions: A retrospective review of pediatric patients with thrombocytopenia, 2011–2016'. Together they form a unique fingerprint.

Cite this