What are the indications for blood transfusion in patients with acute upper gastrointestinal bleeding?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Blood transfusion is indicated in patients with acute upper gastrointestinal bleeding who are actively bleeding and have a platelet count of less than 50 x 10/litre, or have a prothrombin time (or INR) greater than 1.5 times normal, especially if bleeding is ongoing .

It is also recommended for patients with severe bleeding or haemodynamic instability, as part of resuscitation and management .

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