International platelet guideline makes list of 2025’s most-viewed publications in high-impact medical journal

A recent guideline produced by AABB and ICTMG to provide evidence-based recommendations on platelet transfusion has earned a spot among the most popular articles in the peer-reviewed medical journal, JAMA.

JAMA is recognized as a high-impact journal in the medical community. It published the AABB and ICTMG’s 2025 international clinical practice guidelines on platelet transfusion in May 2025. 

According to metrics available on the journal’s website, the clinical guideline has been viewed over 120,000 times and cited 20 times already. That’s quite the buzz for a publication still a few months shy of its first birthday, but it certainly shows the publication is piquing the interest of knowledge mobilizers and clinical practitioners across the transfusion medicine field.

Why the interest in this guideline? 

Platelets are a frequently transfused blood component for adult and pediatric patients in a variety of clinical settings and their demand is increasing. However, differences in dosing recommendations and thresholds that dictate how platelets should be used have been acknowledged for some time, including in systematic reviews dating back to 2021. To address these areas of uncertainty, expert volunteers from the international collaborative, ICTMG, teamed up with AABB (the Association for the Advancement of Blood & Biotherapies). Together they created this much-anticipated new guideline through rigorous development processes to provide clear recommendations for the alignment of platelet transfusion best practices with current evidence. 

“The implementation of these platelet guidelines is important since Canada, as well as other jurisdictions, are seeing continual growth of 7-9% per year in the demand for platelets.  

Understanding the utilization by indication will help with forecasting additional growth, management of shortages and highlight areas to be targeted for improvement.” 

Dr. Susan Nahirniak, transfusion medicine physician and guideline co-author

From the Canadian perspective, a recent analysis of platelet transfusion practice in Ontario-based hospitals has shared that of nearly 57,000 platelet transfusion events occurring during the study period, an estimated 23 per cent are not in-line with the guidelines’ recommendations for best practices. (Note: This analysis, published in December 2025, was made possible with the support of one of Canadian Blood Services’ competitive research funding programs).

Who are the guideline’s authors and what is ICTMG? 

The lead authors of the AABB and ICTMG platelet guideline include Dr. Ryan Metcalf, a Utah-based transfusion medicine section chief and blood bank medical director, and Dr. Susan Nahirniak, a transfusion medicine physician and medical director for transfusion & transplantation medicine at Alberta Precision Laboratories in Alberta. 

Other well-recognized names who contributed their expertise to this guideline include Dr. Gordon Guyatt, a professor and leader in the field of health research methodologies located at McMaster University in Ontario, and Dr. Simon Stanworth, the U.K.-based Executive Chair of the ICTMG and haematology expert who has published extensively in transfusion medicine. 

With a mission to inform the right transfusion, always, everywhere, the International Collaboration for Transfusion Medicine Guidelines (ICTMG) is an independent collaborative of volunteers with expertise in transfusion medicine and related clinical disciplines, guideline development methodology and implementation research. The ICTMG Secretariat is hosted by Canadian Blood Services, which is the primary funder for ICTMG.  

Where can I find out more about this guideline? 

Dr. Metcalf joined JAMA’s Clinical reviews podcast to discuss the guideline and its recommendations for liberal or restrictive transfusion strategies in a 13-minute episode back in May 2025. 

Continuing the knowledge mobilization efforts, Dr. Nahirniak and Dr. Metcalf also completed a December 2025 presentation about the guideline for healthcare providers as part of the University of Toronto's Transfusion Medicine Rounds.  

The ICTMG team will also be launching a dedicated knowledge mobilization project in early 2026 and is continuing to collaborate with researchers at the Ottawa Hospital Research Institute (OHRI) on an implementation research project to enhance understanding of barriers and facilitators to effective behavioural change for healthcare providers when applying guideline recommendations in practice. 

Access the podcast and connect with other knowledge mobilization resources as they become available throughout the year ahead: 

Platelets 2025 | ICTMG

Watch the recording of Dr. Nahirniak and Dr. Metcalf’s Transfusion Medicine Rounds presentation on the U of T Transfusion Medicine Rounds Youtube channel: 

Transfusion medicine rounds

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The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.