[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-446213-105":59,"doc-detail-446213-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","platelet-transfusion-in-end-of-life-adult-care-letter-to-the-editor","Platelet transfusion in end-of-life adult care - Letter to the Editor","","A letter to the editor argues that platelet transfusion decisions in adults require more than laboratory counts, especially in palliative and end-of-life settings. It contrasts standard protocols for active bleeding and prophylaxis with emerging evidence to tailor transfusion policy to individual bleeding risk and care objectives. The authors highlight clinical and ethical concerns, noting limited hemostatic duration and low but real risks, and provide five multidisciplinary recommendations focused on comfort, limiting futile prophylaxis, and respecting autonomy.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/platelet-transfusion-in-end-of-life-adult-care-letter-to-the-editor/446213/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/platelet-transfusion-in-end-of-life-adult-care-letter-to-the-editor/446213.png","ImageObject",300,407,{"name":92,"@type":93},"วิน","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why should platelet transfusion decisions not rely only on platelet counts in end-of-life care?","Question",{"text":112,"@type":113},"Emerging evidence suggests transfusion policies should be adapted to each patient’s bleeding risk and care objectives. Factors such as bleeding history and comorbid conditions influence risk beyond the platelet count.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What ethical concerns are raised about prophylactic platelet transfusions in terminal patients?",{"text":117,"@type":113},"The letter describes significant clinical and ethical concerns, including the focus on quality of life, the risk of adverse reactions, and the limited benefit of prophylaxis in late-stage disease. It frames these issues through non-maleficence, beneficence, justice, and autonomy.",{"name":119,"@type":110,"acceptedAnswer":120},"What recommendations are proposed to guide platelet transfusion in adult end-of-life care?",{"text":121,"@type":113},"Recommendations include identifying disease stage and goals before transfusion, focusing decisions on comfort and symptom burden, avoiding prophylactic transfusions, carefully weighing bleeding-risk procedures, preferring platelet pools over single concentrates, and ensuring truly informed consent and use of advance directives when needed.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},446213,1791086696,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},2336475104736,"https://ap-avatar.wpscdn.com/avatar/22000c4c5e0e5b17e70?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786591360781797222","hematol transfus cell ther. 2026;48(1):106228  \nHematology, Transfusion and Cell Therapy  \n[www. htct. com. br](www. htct. com. br)  \nLetter to the Editor  \nPlatelet transfusion in end-of-life adult care    \nDear Editor,  \nIn a tertiary care hospital, where the complexity of patients treated has increased over the years, the decision to transfuse each individual that presents with anemia or thrombocytopenia must be guided not only by clinical and laboratory characteristics, but also by the availability of blood products, ensuring judicious and ethical use of this scarce resource. In our hospital, despite a continuous effort to increase platelet collections, transfusion demands continue to rise, requiring careful and continuous reassessment of transfusion practices.  \nCurrent protocols recommend platelet transfusion in case of active hemorrhage or, prophylactally, for high-risk bleeding procedures in patients with severe thrombocytopenia or under antiplatelet therapy, and for spontaneous bleeding prevention in severe thrombocytopenia cases [1−3] . In asymptomatic patients with platelet counts \u003C10 £ 103/mL or \u003C20 £ 103/mL if other bleeding risk factors exist, platelet transfusion is intended, in particular, to reduce the likelihood of intracerebral bleeding [1−4] .  \nHowever, emerging evidence suggests that transfusion policies should not rely solely on platelet counts, but instead be adapted to each patient’s bleeding risk (also associated with personal history of bleeding, renal failure, hypoalbuminemia, fever, or recent stem cell transplantation [5]) and care objectives, particularly in palliative and end-of-life settings [6,7] .  \nIn this population, prophylactic transfusions raise signifi cant clinical and ethical concerns: based on the stage of the disease and estimated life expectancy, the level of care should focus on optimizing quality of life. In these cases, efforts should be made to discontinue all treatments that do not directly contribute to the patient’s comfort and that do not aim for symptom control or achieving realistic goals [8,9] .  \nIn hemato-oncologic terminal patients, disease-specific treatments are often continued, resulting in frequent hospital visits and admissions, intensive care interventions, and high intrahospital mortality rates [10,11] . Unlike erythrocyte transfusions, that may provide symptomatic relief, prophylactic platelet transfusion has not consistently been associated with a reduction in bleeding complications or an improved survival in terminal patients [5,12,13] .  \nIt is known that terminal patients often face repeated hospital visits for transfusions, resulting in discomfort and stress for them and their caregivers. Nonetheless, each transfusion carries approximately a 1% risk of severe adverse reactions, and its hemostatic effect is short-lived [14−18] . As such, providing platelet transfusions in end-of-life care involves complex ethical principles:  \n􀀁 Non-maleficence: Restrictive prophylactic transfusion policies may prevent harm by avoiding frequent hospital trips, invasive testing, and treatment-related adverse effects that offer limited benefit in late-stage disease. Unnecessary transfusions may delay timely transition to palliative care, potentially diminishing quality of life.  \n􀀁 Beneficence: Avoiding futile treatments helps spare patients from side effects and unnecessary interventions, promoting well-being.  \n􀀁 Justice: Platelet components are scarce; clinical judgment should ensure equitable distribution while addressing individual needs.  \n􀀁 Autonomy: Patients must receive complete information about transfusion risks and benefits, allowing their preferences and advance directives to guide treatment decisions.  \nBased on a literature review and multidisciplinary discussion at our hospital, we proposed the following recommendations for platelet transfusion in adult patients in end-of-life care:  \nRecommendation 1: Clinical records must identify their disease stage and care obje","cbCaio1IMh6XsfUP","https://ap.wps.com/l/cbCaio1IMh6XsfUP","pdf",278856,"English","# Letter to the Editor\n## Rationale for individualized transfusion decisions\n## Current protocol limits in end-of-life settings\n## Ethical principles\n## Recommendations for adult end-of-life platelet transfusion\n## Conclusion","[{\"question\":\"Why should platelet transfusion decisions not rely only on platelet counts in end-of-life care?\",\"answer\":\"Emerging evidence suggests transfusion policies should be adapted to each patient’s bleeding risk and care objectives. Factors such as bleeding history and comorbid conditions influence risk beyond the platelet count.\"},{\"question\":\"What ethical concerns are raised about prophylactic platelet transfusions in terminal patients?\",\"answer\":\"The letter describes significant clinical and ethical concerns, including the focus on quality of life, the risk of adverse reactions, and the limited benefit of prophylaxis in late-stage disease. It frames these issues through non-maleficence, beneficence, justice, and autonomy.\"},{\"question\":\"What recommendations are proposed to guide platelet transfusion in adult end-of-life care?\",\"answer\":\"Recommendations include identifying disease stage and goals before transfusion, focusing decisions on comfort and symptom burden, avoiding prophylactic transfusions, carefully weighing bleeding-risk procedures, preferring platelet pools over single concentrates, and ensuring truly informed consent and use of advance directives when needed.\"}]","Platelet transfusion in end-of-life adult care - Letter to the Editor | PDF",1790714462]