The Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P) program links blood donors to pediatric transfusion recipients to study vein-to-vein associations and better understand donor, recipient, and blood processing factors that may affect transfusion outcomes. Using the REDS-IV-P database, researchers retrospectively analyzed data from pediatric inpatient encounters, including neonates younger than 28 days with a birthweight greater than 2500 grams, older infants, and children up to 18 years of age across 29 blood centers and hospitals. Among 249,340 patient encounters, 3.6% of neonates and children (median age, 2.5 years) received prophylactic platelet transfusions, with infants younger than one year receiving the fewest (2.6%) and children one to six years old receiving the most (4.7%). Over two-thirds of platelet transfusions were administered at pre-transfusion platelet counts greater than 25 X 103/µL for neonates and greater than 10 X 103/µL for children. However, transfusion efficacy, based on platelet count increments pre- and post-transfusion, was highest when platelets were transfused below these thresholds for both neonates and children. Transfusion efficacy was significantly lower, and patients were more likely to receive a subsequent transfusion, when platelets were pathogen reduced, stored longer than three days, or obtained from donors older than 40 years.
References:
- Delaney M. Advancing Pediatric Platelet Transfusion—From Vein to Vein. JAMA Netw Open. 2026;9(1):e2554490. doi:10.1001/jamanetworkopen.2025.54490
- Goel R, Karam O, Warden DE, Birch RJ et al. Platelet Transfusion Practices and Outcomes in Neonates and Children. JAMA Netw Open. 2026;9(1):e2554531. doi:10.1001/jamanetworkopen.2025.54531
