Introduction — This topic includes links to society and government-sponsored guidelines from selected countries and regions around the world. We will update these links periodically; newer versions of some guidelines may be available on each society's website. Some societies may require users to log in to access their guidelines.
The recommendations in the following guidelines may vary from those in UpToDate topic reviews. Readers who are looking for UpToDate topic reviews should use the UpToDate search box to find the relevant content.
Links to related guidelines are provided separately. (See "Society guideline links: Sickle cell disease and thalassemias" and "Society guideline links: Pediatric iron deficiency".)
International
●World Health Organization (WHO): Guideline on use of ferritin concentrations to assess iron status in individuals and populations (2020)
●International Consensus Conference (ICC): Recommendations from the 2018 Frankfurt Consensus Conference on patient blood management (published 2019)
●AABB: Clinical practice guidelines for red blood cell transfusion thresholds and storage (2016)
●WHO: Guideline on daily iron supplementation in adult women and adolescent girls (2016)
●WHO: Guideline on iron supplementation in postpartum women (2016)
●WHO: Guideline on the use of multiple micronutrient powders for point-of-use fortification of foods consumed by pregnant women (2016)
●International Council for Standardization in Haematology (ICSH): Guidelines for the laboratory diagnosis of nonimmune hereditary red cell membrane disorders (2015)
●Kidney Disease: Improving Global Outcomes (KDIGO): Clinical practice guideline for anemia in chronic kidney disease (2012)
●WHO: Guideline on intermittent iron and folic acid supplementation in menstruating women (2011)
Canada
●National Advisory Committee on Blood and Blood Products (NAC): Position paper for utilization and inventory management of group O RH(D) – Negative red cells (2016, revised 2022)
●NAC: Position statement on patient blood management (2022)
●Choosing Wisely Canada: Don't order unnecessary pre-transfusion testing (type and screen) for all pre-operative patients (updated 2021)
●Choosing Wisely Canada: Don't routinely order perioperative autologous and directed blood collection (updated 2021)
●Choosing Wisely Canada: Don't transfuse blood if other non-transfusion therapies or observation would be just as effective (updated 2021)
●Choosing Wisely Canada: Don't transfuse more than one red cell unit at a time when transfusion is required in stable, non-bleeding patients (updated 2021)
●Choosing Wisely Canada: Don't transfuse O negative blood except to O negative patients and in emergencies for female patients of child-bearing potential of unknown blood group (updated 2021)
United States
●American Gastroenterological Association (AGA): Clinical practice guidelines on the gastrointestinal evaluation of iron deficiency anemia (2020)
●Choosing Wisely: Avoid using hemoglobin to evaluate patients for iron deficiency in susceptible populations. Instead, use ferritin (2020)
●Choosing Wisely: Do not transfuse red blood cells as the sole intervention for expansion of circulatory volume unless deemed necessary for patients experiencing severe hemorrhage (2020)
●American Society of Clinical Oncology (ASCO)/American Society of Hematology (ASH): Clinical practice guideline for the management of cancer-associated anemia with erythropoiesis-stimulating agents, update (2019)
●Choosing Wisely: Do not perform peripheral blood flow cytometry to screen for hematological malignancy in the settings of mature neutrophilia, basophilia, erythrocytosis, thrombocytosis, isolated anemia, or isolated thrombocytopenia (2018)
●Choosing Wisely: Don't perform laboratory blood testing unless clinically indicated or necessary for diagnosis or management in order to avoid iatrogenic anemia (2018)
●Choosing Wisely: Don't proceed with elective surgery in patients with anemia until properly diagnosed and treated (2018)
●Choosing Wisely: Don't transfuse more than the minimum of red blood cell (RBC) units necessary to relieve symptoms of anemia or to return a patient to a safe hemoglobin range (7 to 8 g/dL in stable patients) (2018)
●Choosing Wisely: Do not order red blood cell folate levels at all. In adults, consider folate supplementation instead of serum folate testing in patients with macrocytic anemia (2017)
●Choosing Wisely: Don't routinely transfuse stable, asymptomatic hospitalized patients with a hemoglobin level greater than 7–8 grams (2016)
●US Preventive Services Task Force (USPSTF): Final recommendation statement on iron deficiency anemia in pregnant women – Screening and supplementation (2015)
●Choosing Wisely: Don't perform serial blood counts on clinically stable patients (updated 2022)
●Choosing Wisely: Don't routinely transfuse patients with sickle cell disease (SCD) for chronic anemia or uncomplicated pain crisis without an appropriate clinical indication (2014)
●Choosing Wisely: Don't transfuse more units of blood than absolutely necessary (2022)
●Choosing Wisely: Don't transfuse O negative blood except to O negative patients and in emergencies for women of child bearing potential with unknown blood group (updated 2022)
●Choosing Wisely: Don't transfuse red blood cells for iron deficiency without hemodynamic instability (updated 2022)
●Choosing Wisely: Don't transfuse red blood cells in hemodynamically stable, non-bleeding ICU patients with a hemoglobin concentration greater than 7 g/dL (2014)
●Choosing Wisely: Avoid transfusions of red blood cells for arbitrary hemoglobin or hematocrit thresholds and in the absence of symptoms of active coronary disease, heart failure or stroke (updated 2021)
●Choosing Wisely: Don't administer packed red blood cells (PRBCs) in a young healthy patient without ongoing blood loss and hemoglobin of ≥6 g/dL unless symptomatic or hemodynamically unstable (2013)
●Choosing Wisely: Don't transfuse more than the minimum number of red blood cell (RBC) units necessary to relieve symptoms of anemia or to return a patient to a safe hemoglobin range (7 to 8 g/dL in stable, non-cardiac in-patients) (2013)
●Society of Critical Care Medicine (SCCM) and the Eastern Association for the Surgery of Trauma (EAST): Clinical practice guideline – Red blood cell transfusion in adult trauma and critical care (2009)
Europe
●European Society for Medical Oncology (ESMO): Clinical practice guidelines for the management of anaemia and iron deficiency in patients with cancer (2018)
●European Hematology Association (EHA): Recommendations regarding splenectomy in hereditary hemolytic anemias (2017)
●European Crohn's and Colitis Organization (ECCO): European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases (2015)
●European Renal Best Practice (ERBP): A position statement for anaemia management in patients with chronic kidney disease (2009)
United Kingdom
●British Society for Haematology (BSH): Guideline for the laboratory diagnosis of iron deficiency in adults (excluding pregnancy) and children (2021)
●British Society of Gastroenterology (BSG): Guidelines for the management of iron deficiency anaemia in adults (2011, updated 2021)
●National Institute for Health and Care Excellence (NICE): Guideline on chronic kidney disease – Assessment and management (2021)
●BSH: UK guidelines on the management of iron deficiency in pregnancy (2019)
●Choosing Wisely UK: Royal College of Pathologists – Don't give a patient a blood transfusion without informing them about the risks and benefits (although do not delay emergency transfusions) (2018)
●Choosing Wisely UK: Royal College of Pathologists – Don't transfuse red cells for iron deficiency anaemia without haemodynamic instability (2018)
●BSH: Guidelines on the diagnosis and management of adult aplastic anaemia (2015, updated 2017)
●BSH: Guidelines on the management of drug-induced immune and secondary autoimmune haemolytic anaemia (2017)
●BSH: Guidelines on the diagnosis and management of primary autoimmune haemolytic anaemia (2016)
●Choosing Wisely UK: Faculty of Intensive Care Medicine – Blood transfusions should only be given when the haemoglobin is less than 70 g/L. Blood transfusions may occur above this level where the patient is haemodynamically unstable or actively bleeding (2016)
●Choosing Wisely UK: Royal College of Pathologists – Use restrictive thresholds for patients needing red cell transfusions and give only one unit at a time except when the patient has active bleeding (2016)
●NICE: Quality standard on blood transfusion (2016)
●BCSH: Guidelines on the identification and management of pre-operative anaemia (2015)
●NICE: Guideline on blood transfusion (2015)
●BCSH: Guideline for the laboratory diagnosis of functional iron deficiency (2013)
●BCSH: Guidelines on the management of anaemia and red cell transfusion in adult critically ill patients (2012)
Australia-New Zealand
●Choosing Wisely Australia: Do not transfuse red blood cells for iron deficiency where there is no haemodynamic instability
●National Blood Authority (NBA): Patient blood management guidelines
•Medical (2012)
•Perioperative (2012)
•Critical bleeding/massive transfusion (2011)
Japan
●[in Japanese] Transfusion guidelines for patients with massive bleeding (2019)
●[In English] Japanese Society for Dialysis Therapy (JSDT): 2015 guidelines for renal anemia in chronic kidney disease (published 2017)
●[In Japanese] JSDT: 2015 guideline for renal anemia in chronic kidney disease (published 2016)
