Complementary Models for Implementing 2025 Platelet Transfusion Guidance: Targeted Procedural Thresholds and Systemwide Real-time Triage

Proposed Session Description: Health systems are actively working to implement the 2025 AABB platelet transfusion guidance, including more restrictive platelet thresholds for invasive procedures such as diagnostic lumbar puncture. While the evidence supporting restrictive transfusion practices is well established, translating national guidance into consistent, sustainable local practice remains challenging due to variability in governance structures, clinical workflows, stakeholder engagement, and platelet inventory pressures.
This interprofessional session presents a comparative implementation experience from two large health systems that adopted distinct but complementary operational strategies. One institution implemented a targeted procedural platelet threshold ( < 20×10³/µL for adult diagnostic lumbar puncture) through a patient blood management–led, multidisciplinary governance process involving procedural specialists, transfusion medicine, nursing, and laboratory leadership. The second institution implemented a systemwide real-time platelet triage standard operating procedure for nontrauma, non–operating room transfusion requests, led by transfusion medical direction and supported by ongoing PBM monitoring rather than universal threshold replacement.
Attendees will be guided through the rationale, governance structures, workflow integration, and operational considerations that informed each model. Comparative outcomes, including platelet waste reduction, laboratory compliance, transfusion utilization, and process reliability, will be reviewed to illustrate how different approaches can achieve stewardship and patient safety goals. Emphasis will be placed on multidisciplinary collaboration, role clarity across the care team, and aligning implementation strategy with institutional culture and clinical complexity.
The session will be presented by two co‑presenters representing complementary health system perspectives and is designed for laboratory professionals, physicians, nurses, PBM leaders, and operational stakeholders seeking practical, transferable strategies for implementing platelet transfusion guidance through team‑based practice change.