commonly require platelet transfusion support throughout their treatment course. Several studies have provided evidence that the threshold for pro-phylactic platelet transfusion can be lowered to 10 109/L.4,13-15 This thresh-old is similar for hematopoietic stem cell transplantation. If the patient has fever, sepsis, disseminated intravas- Methods. These guidelines are based on many years experience in the use of platelet transfusions by the authors, on searching the literature in MedLine and other databases using appropriate keywords, and a review of the existing guidelines published by expert groups [British Committee for Standards in Haematology (BCSH), 1992; Schiffer et al, 2001], including a previous guideline on platelet Approximate Per-Unit Risks for Platelet Transfusion in the United States Adverse Event Approximate Risk per Platelet Transfusion Reference Febrilereaction 1/14 6 Allergic reaction 1/50 7 Bacterialsepsis 1/75000 8 TRALI* 1/138000 9 HBVinfection 1/2652580 Personalcommunication† HCVinfection 1/3315729 Personalcommunication† Introduction. Thrombocytopenia, defined as a platelet count <150 × 10 9 /L, affects 18-35% of all patients admitted to the Neonatal Intensive Care Unit (NICU). Its incidence is inversely proportional to the gestational age, reaching ~70% among extremely low birth weight infants (ELBW) with BW <1000 g [1-5].Neonatal thrombocytopenia has been invoked as a potential contributor to the high 2 Although a national audit of platelet use in haematology identified that 28% of transfusions were outside of guidelines (Estcourt, et al 2012b) these findings demonstrate less inappropriate use than a previous audit (Qureshi, et al 2007). An increase in the proportion of inappropriate use is therefore unlikely to have Although a national audit of platelet use in haematology identified that 28% of transfusions were outside of guidelines (Estcourt et al, 2012a), Avoid platelet transfusion in renal failure because infused platelets will acquire a dysfunction similar to the patients' own platelets and platelet transfusion may result in alloimmunisation (1B The demand for platelet transfusions has steadily increased in recent years, straining a platelet supply that is already limited due to its dependency on volunteer donors, short shelf life (5 days), risk of infections, and refractoriness, which is the failure to correct platelet numbers following transfusion (Whitaker and Hinkins, 2011). The AABB recommends transfusing hospitalized adult patients with a platelet count of 10 × 109 cells/L or less to reduce the risk for spontaneous bleeding. The AABB recommends transfusing up to a Use of platelet transfusions prior to lumbar punctures or epidural anaesthesia for the prevention of complications in people with thrombocytopenia. Cochrane Database of Systematic Reviews 2018; (4):CD011980. Access abstract: PubMed / full text: Wiley (subscription may be required) Estcourt LJ, Malouf R, Murphy M. Platelet Transfusion Threshold in the Setting of Hematopoietic Stem Cell Transplantation. Platelet Transfusion in Patients with Chronic, Stable, Severe Thrombocytopenia Who Are Not Receiving Active Treatment. Platelet Transfusion Threshold in Patients With Solid Tumors. Platelet Count at which Surgical or Invasive Procedures May Be Performed. Prophylactic versus therapeutic-only platelet transfusions. International guidelines recommend that platelets transfusions are