AM24-ST-18-O: AABB RBC and Platelet International Guidelines: What is New: Liberally Restrictive and Restrictively Liberal? (Enduring)

The AABB continues to update and develop clinical transfusion guidelines as new evidence becomes available. In the past year AABB collaborated with international professional societies and relevant experts to develop and update guidelines for platelets and for RBC transfusions in patients undergoing a myocardial infarction. The platelet effort is the first update since AABB and the International Collaboration for Transfusion Medicine Guidelines (ICTMG) published separate guidelines in 2015. The new guidelines discussed in this section were a collaborative effort between the AABB and ICTMG, and also included other international organizations [[International Collaboration for Transfusion Medicine Guidelines (ICTMG), the International Society of Blood Transfusion (ISBT), and others]. The RBC guideline for patients with myocardial infarction (MI) is the first for this patient population.

During this session, we will briefly discuss the place of guidelines as a tool for changing transfusion practice and also review the guideline development process using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Next we will provide an overview of the platelet guidelines with updates to recommendations for specific patient populations, including: hypoproliferative thrombocytopenia; procedures; critical illness; cardiac surgery; and intracranial hemorrhage. We will then review the main clinical trials evaluating red blood cell transfusion thresholds in patients with myocardial infarction and present the results of the meta-analysis and summary of findings for critical outcomes. Finally, the provisional language of the new AABB RBC MI guideline will be discussed.