TY - JOUR T1 - Two-year outcomes following a randomised platelet transfusion trial in preterm infants JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed DO - 10.1136/archdischild-2022-324915 SP - fetalneonatal-2022-324915 AU - Carmel Maria Moore AU - Angela D’Amore AU - Suzanne Fustolo-Gunnink AU - Cara Hudson AU - Alice Newton AU - Beatriz Lopez Santamaria AU - Alison Deary AU - Renate Hodge AU - Valerie Hopkins AU - Ana Mora AU - Charlotte Llewelyn AU - Vidheya Venkatesh AU - Rizwan Khan AU - Karen Willoughby AU - Wes Onland AU - Karin Fijnvandraat AU - Helen V New AU - Paul Clarke AU - Enrico Lopriore AU - Timothy Watts AU - Simon Stanworth AU - Anna Curley A2 - , Y1 - 2023/02/21 UR - http://fn.bmj.com/content/early/2023/02/20/archdischild-2022-324915.abstract N2 - Objective Assess mortality and neurodevelopmental outcomes at 2 years of corrected age in children who participated in the PlaNeT-2/MATISSE (Platelets for Neonatal Transfusion - 2/Management of Thrombocytopenia in Special Subgroup) study, which reported that a higher platelet transfusion threshold was associated with significantly increased mortality or major bleeding compared to a lower one.Design Randomised clinical trial, enrolling from June 2011 to August 2017. Follow-up was complete by January 2020. Caregivers were not blinded; however, outcome assessors were blinded to treatment group.Setting 43 level II/III/IV neonatal intensive care units (NICUs) across UK, Netherlands and Ireland.Patients 660 infants born at less than 34 weeks’ gestation with platelet counts less than 50×109/L.Interventions Infants were randomised to undergo a platelet transfusion at platelet count thresholds of 50×109/L (higher threshold group) or 25×109/L (lower threshold group).Main outcomes measures Our prespecified long-term follow-up outcome was a composite of death or neurodevelopmental impairment (developmental delay, cerebral palsy, seizure disorder, profound hearing or vision loss) at 2 years of corrected age.Results Follow-up data were available for 601 of 653 (92%) eligible participants. Of the 296 infants assigned to the higher threshold group, 147 (50%) died or survived with neurodevelopmental impairment, as compared with 120 (39%) of 305 infants assigned to the lower threshold group (OR 1.54, 95% CI 1.09 to 2.17, p=0.017).Conclusions Infants randomised to a higher platelet transfusion threshold of 50×109/L compared with 25×109/L had a higher rate of death or significant neurodevelopmental impairment at a corrected age of 2 years. This further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants.Trial registration number ISRCTN87736839.Data are available upon reasonable request. Data will be available upon reasonable request, with approval of the trial group. ER -