Platelets play a crucial role in a variety of physiologic and pathologic processes, especially in hemostasis and wound healing. In recent years platelet-rich plasma, platelet-rich fibrin, platelet-lysate and other platelet-derived products have become a promising treatment in regenerative medicine and have been widely applied clinically. By release a variety of growth factors, cytokines, and chemokines, platelet-derived products induce cell migration, proliferation, differentiation, and chemotaxis, stimulating mitosis in multiple cell types and neovascularization, increasing endothelial cell response to pro-angiogenic factors, and promoting fibroblast migration and proliferation. This article reviews the classification and origin of platelet-derived products, biological characteristics of the main growth factors, and their therapeutic effects in promoting the healing of various wounds, then, also analyzed the possible issues and the future development possibilities.

In recent years, the mechanisms of platelet aging have garnered increasing attention. With advancements in detection technologies, researchers are now able to study the age stratification of platelets in the peripheral blood of healthy individuals, revealing extensive changes at both the transcriptomic and proteomic levels during the aging process. Pathophysiological studies have further elucidated the critical role of platelets in various diseases, closely associated with age-related changes in platelets. However, the specific characteristics of platelet aging and their precise role in disease development remain to be fully elucidated. Therefore, understanding the physiological characteristics and molecular mechanisms of aging platelets under normal conditions is crucial for research. This review summarizes the transcriptomic and proteomic studies on platelet aging in physiological conditions, as well as the changes in platelet turnover in related diseases, aiming to provide a reference for exploring the relationship between platelet aging and disease development.

In May 2025, the Association for the Advancement of Blood and Biotherapies (AABB) and the International Collaboration for Transfusion Medicine Guidelines (ICTMG) jointly released the updated Guidelines for Platelet Transfusion. Based on 21 Randomized Clinical Trials (RCTs) and 13 high-quality observational studies, the guideline adopted the Grading of Recommendations Assessment Development and Evaluation (GRADE) system for evidence analysis, and established the "restrictive platelet transfusion strategy" as the core, aiming to promote the standardization and homogenization of global platelet transfusion practices. The guideline has a wide scope of application, covering different populations such as adults, children, and neonates, including patients with hematological diseases, stem cell transplant recipients, perioperative patients, dengue fever patients, and those undergoing invasive procedures. It sets minimal important differences (MIDs) thresholds for three key outcomes—mortality (2%), grade 2-4 bleeding (20%), and grade 3-4 bleeding (5%)—for evidence certainty grading. In terms of key recommendations, it clarifies strong recommendations with high/moderate certainty of evidence (e.g., transfusion for patients with non-bleeding thrombocytopenia undergoing chemotherapy or allogeneic stem cell transplantation when platelet count<10×10 ⁹/L; transfusion for neonates with consumptive thrombocytopenia without severe bleeding when count<25×10 ⁹/L; no transfusion for dengue fever patients without major bleeding, etc.) and conditional recommendations with low/very low certainty of evidence (e.g., conditional non-recommendation of prophylactic transfusion for adult patients undergoing autologous stem cell transplantation; conditional transfusion for adult patients undergoing central venous catheterization when count<10×10 ⁹/L, etc.). Meanwhile, it elaborates on common platelet transfusion reactions and their risks, such as allergic reactions, febrile reactions, and transfusion-related acute lung injury (TRALI). By lowering transfusion thresholds and refining risk stratification, the guideline can reduce unnecessary transfusions and related adverse reactions, and alleviate the shortage of platelet resources. In the future, it is necessary to further supplement evidence-based evidence in fields such as cardiopulmonary bypass and interventional radiology, and explore technologies like in vitro induced differentiation of platelets and universal engineered platelets to optimize transfusion practices.

Aplastic anemia (AA) is a bone marrow hematopoietic failure disease. Blood component transfusion is necessary to treat anemia and maintain quality of life in AA patients. However, long-term blood transfusion easily leads to transfusion dependence, and the current blood supply is insufficient, and it is also increasingly difficult to meet the blood transfusion needs of AA patients. Therefore, it is particularly important to perform "patient blood management" (PBM) for AA, apply various non-transfusion methods to treat anemia, reduce the transfusion of allogeneic blood, and improve the quality of life of AA patients. Traditional Chinese medicine (TCM) treatment can improve the symptoms of anemia in AA patients, reduce the need for allogeneic blood transfusion, and facilitate the blood management of AA patients. This article reviews the traditional Chinese medicine and its mechanism of action in the treatment of AA, and discusses the clinical significance of traditional Chinese medicine in the blood management of AA patients.

Fetomaternal hemorrhage (FMH) is a series of reactions in which fetal red blood cells enter the maternal circulation before or during delivery, and the mother produces antibodies against fetal red blood cells, which in combination with red blood cell surface antigens cause fetal red blood cells to undergo varying degrees of hemolysis. Accurate quantification of fetalmaternal hemorrhage is crucial for the prevention of neonatal birth defects including neonatal hemolytic disease. Based on the latest relevant literature at home and abroad, this article analyzes the new and traditional detection methods for FMH, elucidates the advantages and shortcomings of various detection methods, and briefly outlines the correlation between FMH and various perinatal fetal clinical disorders, in order to provide a basis for standardization of testing techniques for fetalmaternal hemorrhage and further prevention and treatment of related diseases.

Non-transfusional hemotherapy should be mainly carried out by the Transfusion Department, which basis is the apheresis technology by centrifugation. The plasmapheresis can be realized in two ways: centrifugal and membrane filtration, each of which has its own technical characteristics. Apheresis/blood purification based on centrifugation shows the advantages of higher plasma separation efficiency, shorter treatment time, less platelet loss, less destruction of red blood cells, and the use of citrate anticoagulation for non-continuous clinical treatment of critically ill patients. Secondary columns suitable for centrifugal technology can realize immunoadsorption, artificial liver support system, centrifugation-filtration plasmapheresis and inflammatory factor adsorption. Using increasingly sophisticated secondary column technology should be a useful supplement to traditional TPE.

Cell-free fetal DNA (cff-DNA) exists in the peripheral blood of pregnant women during gestation, and it carries DNA fragments with relevant genetic information of the fetus, which can be screened for fetal chromosomal and gene-related diseases. It is now widely used in non-invasive prenatal testing (NIPT) because of its low operational risk and lack of side effects. Non-invasive cff-DNA blood group testing uses molecular technology to detect the genes associated with cff-DNA blood grouping, resulting in a fetal blood group. The test can be used to detect the consistency of fetal and maternal blood groups during pregnancy and to determine the risk of hemolytic disease of the fetus and newborn (HDFN) due to blood group incompatibility.

To date, the proliferation of life science and medical research involving human participants in Chinese blood collection and supply institutions necessitates the eatablishemnt of medical ethics committees, which conduct ethical reviews to ensure that medical research trials adhere to ethical and legal standards, safeguarding the safety, health, privacy and other rights of study subjects. Taking the Ethics Committee of Nanjing Red Cross Blood Center as a case study, we aimed to explore the standardization process of medical ethics committees within blood collection and supply institutions by evaluating their accomplishments and shortcomings, and we sought to offer insights into the ethical considerations regarding medical device clinical trials using blood samples and donor information from these institutions, thus better protecting the rights and interests of research participants, and fostering the healthy and sustainable growth of blood transfusion medical research within the sector.

Platelet-rich plasma (PRP) is a platelet concentrate that releases various growth factors upon activation and plays an important role in promoting tissue repair. Currently PRP therapy, as a novel technique, has achieved significant clinical results in the treatment and prognosis of many diseases, and has been applied in multiple disciplines such as orthopedics, pain management, and dermatology. In recent years, the application of PRP in reproductive medicine has attracted widespread attention. This article briefly reviews the possible mechanisms of the effect of intrauterine infusion of PRP on endometrial injury repair, providing a theoretical basis for the application of PRP in the treatment of female infertility.

Deficiency of glucose-6-phosphate dehydrogenase (G6PD) can lead to the destruction of red blood cells during oxidative stress responses. Although screening for G6PD deficiency is not currently a routine practice in healthy blood donors, there are reports in the literature that transfusion of RBCs from individuals with G6PD deficiency can lead to hemolysis and other adverse events. Moreover, certain patient populations may be more susceptible to complications associated with the transfusion of G6PD-deficient RBCs. This article reviews the pathogenesis of G6PD deficiency and its clinical challenges in transfusion practice, aiming to improve the effectiveness and safety of blood transfusion for relevant populations.

Occult hepatitis B virus infection (OBI), characterized by extremely low viral loads and the persistent latency of intrahepatic cccDNA, poses a profound challenge to global public health security. Its prevention and control have long been constrained by the sensitivity limitations of conventional diagnostic methods, highlighting the urgent need for technological breakthroughs. Emerging detection technologies are driving progress from multiple perspectives: droplet digital PCR enables ultra-sensitive quantification through micro-compartmentalized amplification; CRISPR-Cas systems coupled with isothermal amplification are advancing the development of point-of-care diagnostics; third-generation sequencing technologies open new dimensions for viral genome analysis; and nanomaterial-mediated signal amplification mechanisms are reshaping screening models at the primary-care level. This review summarizes recent advances in OBI diagnostic technologies, provides a comprehensive analysis of their advantages, limitations, and transfusion-related applications, and offers recommendations to support improved OBI risk control in blood transfusion and the development of novel diagnostic strategies tailored to China's national context.

Sema7a protein, a member of the semaphorin protein family, also known as CDw108 or JMH antigen, is a blood group antigen on the surface of erythrocyte membrane. It's a glycosylphosphatidylinositol (GPI)-anchored glycoprotein widely expressed on the cell membranes of various tissues throughout the body. The Sema7a protein can be cleaved from cell membrane by various physical and chemical factors, such as enzyme, blood shear force and hypoxia. The Sema7a protein on the surface of erythrocyte membrane is the main source of free Sema7a in vivo. The Sema7a protein can bind to two known receptors, integrin or PlexinC1 (PlexinC1), or in a free form to participate in various biological activities throughout the body, and plays an important role in cell differentiation, nerve signal transduction, immune response, inflammation regulation, and tumor progression. This review summarizes the mechanisms of Sema7a protein involvement in the occurrence and development of different diseases based on the classification of systemic disease.

Objective To investigate the clinical significance of third-generation gene sequencing (TGS) in detecting Kidd blood group antigen in weakly expressed samples. Methods Samples of patients in Xinjiang Autonomous Region People's Hospital were collected, Jka and Jkb antigens were detected by serological methods, and 9 cases of weakly expressed samples of Kidd blood group genes were subjected to full-length single-molecule real-time sequencing technology (third-generation high-throughput sequencing) to obtain their gene polymorphisms and statistically analyzed. Results The main mutation sites of the Kidd blood group gene were detected in this study: c.588A>G, c.838G>A, and c.130G>A. In addition, 5 samples were found to have new gene mutation types, with 2 being homozygous and 3 heterozygous. The new mutation gene types were: c.499A>G, c.588A>G, and c.838G>A, which are mainly seen in the Jk(b+) phenotype. The allele name for the new mutation is JK*02.NEW. In 9 samples, 7 of the genetic test results were different from the serological results, and all of them had ISBT-recorded or unrecorded gene mutation sites. At the same time, the specificity of the mutation gene sites and the corresponding amino acid changes were summarized and analyzed. Conclusion The present study investigated the mutation, splicing, folding, and amino acid sequence of the Kidd gene in the Xinjiang population. This research lays a solid foundation for gaining further insights into the specificity of blood groups in this region and provides a fundamental basis for future construction of three-dimensional protein models.

Objective To investigate the clinical characteristics of patients with myelodysplastic syndrome (MDS) complicated with TUBB1 mutations, and the correlation between TUBB1 mutations and platelet transfusion refractoriness. Methods Retrospective research was done. Systematically collect clinical data of 81 patients diagnosed with MDS and treated with chemotherapy at Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from February 2018 to October 2023. Observe the incidence of blood routine, gene mutations, CD34 and platelet transfusion rejection (PTR). The survival curve was plotted using the Kaplan Meier, the PTR risk factor analysis was performed using logistic regression analysis, and the forest map was plotted using R studio. Results Among 81 MDS patients, there were 10 cases in the TUBB1 mutation group and 71 cases in the TUBB1 wild-type group. Compared with TUBB1 wild-type group patients, TUBB1 mutation group patients have a higher proportion of CD34 ⁺MKs [33.50 (14.25, 55.88)% vs. 4.00 (2.00, 10.00)%, P<0.001], decreased platelet count with increased volume [36.00 (18.75, 186.50)×10 ⁹/L vs. 91.00 (67.00, 164.00)×10 ⁹/L, P<0.05; (12.03±1.92) fL vs. (9.19±0.97) fL, P<0.001]. There were 8 cases (80.00%) of PTR in the TUBB1 mutation group, and 18 cases (25.35%) of PTR in the TUBB1 wild-type group. The difference between the two groups was statistically significant ( P<0.05).The results of logistic regression analysis showed that TUBB1 mutation was an independent risk factor for ineffective platelet transfusion therapy ( P<0.05, OR=7.28). Conclusion MDS patients with TUBB1 mutations generally exhibit an increase in the proportion of CD34 ⁺MKs, an increase in platelet volumeand and a decrease in platelet count. TUBB1 mutation is an independent risk factor for PTR during the bone marrow suppression phase after chemotherapy in MDS patients.

Objective To analyze the distribution of HLA/HPA antibody specificity and its influence on the efficacy of platelet transfusion in patients with immune platelet transfusion refractoriness（PTR）. Methods In this study, 86 patients with immune PTR were recruited, and clinical data were collected, including gender, age, height, weight, times of platelet cross-matching, diseases, as well as platelet count before and after platelet transfusion. HLA antibody specificity was determined using the microbead assay. Results Among 86 PTR patients, 72 (83.72%) had HLA antibodies alone, 8 (9.30%) had HPA antibodies alone, and 6 (6.98%) had both HLA and HPA antibodies. The most prevalent HLA alleles corresponding to HLA antibodies in different loci were A*25:01, B*15:12, C*02:02 (and C*17:01), with the positive rates of 81.48%, 87.04%, and 48.15%, while the top antigenic epitopes were 163LG, 97V, and 71ATD, with the positive rates of 87.04%, 77.78%, and 74.07%, respectively. In patients with HLA antibodies alone, cross-matched platelet transfusions showed significantly higher 24 h corrected count increment（CCI）and transfusion efficiency than randomized transfusions (P<0.01). In patients with negative cross-matching results, the intensity of HLA antibodies inversely correlated with both the 24 h CCI and the effective rate of platelet transfusion in patients receiving cross-matched platelets. Specifically, a higher the level of HLA antibodies corresponded to a lower 24 h CCI and reduced transfusion efficiency (P<0.01). Conversely, in patients with a lower level of HLA antibodies, the efficiency of platelet transfusion and 24 h CCI of cross-matched platelets were significantly higher than those of randomized platelets (P<0.05). Conclusion Our findings reveal the specificity of HLA/HPA antibodies in patients with immune PTR and their effect on platelet transfusion efficacy, which would provide guidance for donor selection in the establishment of platelet banks. Furthermore, this study could also provide a reference for selecting appropriate treatment strategies for patients with immune PTR.

Objective To observe efficacy of avatrombopag (AVA) combined with recombinant human thrombopoietin (rhTPO) on platelet (PLT) engraftment in patients with hematological malignancies after autologous hematopoietic stem cell transplantation (ASCT/auto-HSCT). Methods Seventy-six ASCT patients were retrospectively collected, including 40 patients treated with AVA with rhTPO as observation group, and 36 patients treated with rhTPO alone as control group. PLT count, engraftment time, number of PLT transfused, platelet nadir and duration at grade IV thrombocytopenia were compared, and adverse reactions were recorded. Results The PLT engraftment time in observation group was shorter than that in control group (11.15±1.08 vs.12.61±2.65 days, P<0.05), and the number of PLT transfused units was less [2 (1.00,2.75) units vs. 3 (2.00, 4.00) units], ( P<0.001). PLT counts on day 5, day 10 and day 15 in observation group were higher than that in control group, and the rates of platelet engraftment on days 5 and 10 were significantly higher ( P<0.05). Multiple linear regression analysis showed that AVA was an independent factor ( P<0.001), and its use shortened the engraftment time by 1.598 days. Bleeding events were observed in both groups, mainly in petechiae、ecchymosis or gingival bleeding, and no difference in bleeding rate. No thrombosis and coagulation disorders occurred in both groups. Conclusion AVA combined with rhTPO effectively increased PLT count and promoted PLT engraftment. The combination of the two has a synergistic effect and is well tolerated.