Current Status of Platelet Transfusion in Pediatric Patients

•Prophylactic platelet transfusions for children undergoing cancer treatment are not well characterized and require further investigation.•The effect of routine platelet transfusion in pediatric cardiac surgery on postoperative outcome is unknown.•The determination of platelet count threshold before various invasive procedures and clinical settings should be studied.

Outside the neonatal period, most platelets that are transfused to pediatric patients are given to those who are thrombocytopenic secondary to malignancy and associated therapy and/or hematopoietic progenitor cell transplant, or to those with significant bleeding associated with surgery, especially cardiac surgery. Indications for platelet transfusion, doses, and other practices for children largely mimic adult platelet transfusion protocols because there are few pediatric-specific studies in this area. Pediatric platelet transfusion practices would benefit from focused pediatric research. The appropriate indications and doses for platelet transfusions in oncology, hematopoietic progenitor cell transplant, and cardiac surgery patients need to be determined.