Safety of Lowering the Platelet Transfusion Threshold Before Central Venous Catheterisation in Patients With Haematological Diseases
5 affiliations
- 1Department of Clinical Sciences Lund University Lund Sweden
- 2Department of Intensive and Perioperative Care Skåne University Hospital Lund Sweden
- 3Department of Haematology, Oncology and Radiation Physics Skåne University Hospital Lund Sweden
- 4Department of Cardiothoracic Surgery Anaesthesia and Intensive Care Skåne University Hospital Lund Sweden
- 5Department of Anaesthesia and Perfusion The Prince Charles Hospital Brisbane Queensland Australia
Abstract
Introduction: Central venous catheter (CVC) insertion is frequently required in patients with haematological diseases. Despite limited evidence, thrombocytopenia often prompts prophylactic platelet transfusion before catheterisation.
Methods: We conducted an observational before‐and‐after study including the first non‐tunnelled CVC insertion performed in adult patients with haematological diseases between 2013 and 2026 at the Department of Haematology, Skåne University Hospital, Lund, Sweden. In March 2023, the recommended platelet transfusion threshold before CVC insertion was lowered from < 50 × 109/L to < 10 × 109/L. The primary outcome was the proportion of grade 3–4 bleeding events. Secondary outcomes included the proportion of grade 2 bleeding events and transfusion practices.
Results: A total of 992 patients were included (715 before and 277 after implementation). Grade 3–4 bleeding events occurred in 14/715 procedures before implementation and in none of the 277 insertions after implementation (absolute risk difference −2.0%, 95% CI: −3.3 to −0.4; p = 0.014). Grade 2 bleeding events were unchanged (8.5% vs. 6.5%, absolute risk difference −2.0%, 95% CI: −5.2 to 2.0; p = 0.289). Preprocedural platelet transfusions decreased substantially (30% vs. 6.5%; p < 0.001).
Conclusions: Lowering the platelet transfusion threshold to < 10 × 109/L was not associated with increased bleeding complications and reduced platelet transfusion use. These findings support a more restrictive preprocedural transfusion strategy.
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BibTeX
@article{lindblad2026safety,
title = {{Safety of Lowering the Platelet Transfusion Threshold Before Central Venous Catheterisation in Patients With Haematological Diseases}},
author = {Mathias Lazarevic Lindblad and Elin Pålsson and Vladimir Lazarevic and Leila Naddi and Ola Borgquist and Lars Nilsson and Maria Adrian and Björn P. Bark and Thomas Kander},
journal = {European Journal of Haematology},
year = {2026},
month = aug,
doi = {10.1111/ejh.70287},
url = {https://doi.org/10.1111/ejh.70287},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Safety of Lowering the Platelet Transfusion Threshold Before Central Venous Catheterisation in Patients With Haematological Diseases
AU - Mathias Lazarevic Lindblad
AU - Elin Pålsson
AU - Vladimir Lazarevic
AU - Leila Naddi
AU - Ola Borgquist
AU - Lars Nilsson
AU - Maria Adrian
AU - Björn P. Bark
AU - Thomas Kander
PY - 2026
DA - 2026/08/07
JO - European Journal of Haematology
DO - 10.1111/ejh.70287
UR - https://doi.org/10.1111/ejh.70287
AB - Introduction: Central venous catheter (CVC) insertion is frequently required in patients with haematological diseases. Despite limited evidence, thrombocytopenia often prompts prophylactic platelet transfusion before catheterisation. Methods: We conducted an observational before‐and‐after study including the first non‐tunnelled CVC insertion performed in adult patients with haematological diseases between 2013 and 2026 at the Department of Haematology, Skåne University Hospital, Lund, Sweden. In March 2023, the recommended platelet transfusion threshold before CVC insertion was lowered from < 50 × 109/L to < 10 × 109/L. The primary outcome was the proportion of grade 3–4 bleeding events. Secondary outcomes included the proportion of grade 2 bleeding events and transfusion practices. Results: A total of 992 patients were included (715 before and 277 after implementation). Grade 3–4 bleeding events occurred in 14/715 procedures before implementation and in none of the 277 insertions after implementation (absolute risk difference −2.0%, 95% CI: −3.3 to −0.4; p = 0.014). Grade 2 bleeding events were unchanged (8.5% vs. 6.5%, absolute risk difference −2.0%, 95% CI: −5.2 to 2.0; p = 0.289). Preprocedural platelet transfusions decreased substantially (30% vs. 6.5%; p < 0.001). Conclusions: Lowering the platelet transfusion threshold to < 10 × 109/L was not associated with increased bleeding complications and reduced platelet transfusion use. These findings support a more restrictive preprocedural transfusion strategy.
SN - 0902-4441
SN - 1600-0609
ER -