Upper-arm port implantation under restrictive platelet transfusion
Abstract:
The optimal periprocedural platelet transfusion strategy for implantable central venous port placement in patients with hematological diseases remains unclear. We retrospectively evaluated outcomes after upper-arm port implantation under a restrictive platelet transfusion strategy, with prophylactic platelet transfusion only given at counts < 20 × 109/L. This single-center study included 58 procedures in 57 patients between May 2022 and June 2026. The median preprocedural platelet count was 152.5 × 109/L (range, 4-412 × 109/L). Prophylactic platelet transfusion was not given in any of the 3 procedures at counts of 20 to < 50 × 109/L, but preprocedural transfusion was given in all 8 procedures at counts < 20 × 109/L. Intraoperative or postoperative transfusion was also given in 2 procedures during the initial study period. Technical success was achieved in all procedures. No bleeding or hematoma requiring additional intervention was documented, including among the 11 procedures at platelet counts < 50 × 109/L, and no port-related infection was documented. Port exposure occurred in 2 procedures, both requiring removal. These findings provide clinical data on upper-arm port implantation under a restrictive platelet transfusion strategy, including in patients with thrombocytopenia. Larger studies are needed to determine an appropriate platelet transfusion threshold.
Reference:
Okada K, Hisabayashi M, Umakoshi E, Takahashi N, Inoue R, Nashima M, Ito S, Tuchida H, Nagae K, Minakuchi M, Mukaizawa F, Murakami W, Fujieda M, Imanaka T, Nakamura J, Takaya R, Nagayama T, Muranushi H, Sato T, Onishi T, Ueda Y, Maeda T. Clinical outcomes of upper-arm port implantation under restrictive platelet transfusion in hematological diseases. Int J Hematol. 2026 Oct 14. doi: 10.1007/s12185-026-04297-w. Epub ahead of print. PMID: 42873461.