JAMA recently published a guideline addressing management of major procedures in patients with thrombocytopenia, outlining evidence-based platelet transfusion thresholds for various clinical settings.
- Consumptive thrombocytopenia (no major bleeding): <10 × 10³/μL
- Central venous catheter (compressible site): <10 × 10³/μL
- Interventional radiology: <20 × 10³/μL (low risk); <50 × 10³/μL (high risk)
- Major non-neuraxial surgery: <50 × 10³/μL
- Cardiovascular surgery (no major hemorrhage): Not recommended
- Nonoperative intracranial hemorrhage (>100 × 10³/μL or on antiplatelets): Not recommended