Joan Cid1, Mark H Yazer, Miguel Lozano. 1. aDepartment of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clínic, University of Barcelona, Barcelona, Spain bDepartment of Pathology, University of Pittsburgh, The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania, USA.
Abstract
PURPOSE OF REVIEW: Current guidance allows transfusing D-mismatched platelets to D negative recipients when necessitated by logistic constraints. Although the D antigen is not expressed on the platelet membrane, platelet concentrates are still labeled by their D antigen status because the platelet concentrates contain a small quantity of red blood cells. D matching is currently recommended to prevent D alloimmunization based on frequencies of D alloimmunization after transfusing platelet concentrates obtained from whole blood collections of up to 18.7%. RECENT FINDINGS: The content of red blood cells is higher in pooled platelet concentrates prepared from whole blood collections (range: 0.036-0.59 ml) than in platelet concentrates obtained from apheresis devices (range: 0.00017-0.009 ml). Large retrospective studies with long follow-up suggest that it is not possible to rule out a secondary immunization in D negative patients who developed an alloanti-D within 4 weeks after receiving the first D-mismatched platelet transfusion, and the frequency of D alloimmunization after D-mismatched platelet transfusions ranges between 0 and 7.1%. SUMMARY: Based on the reported frequencies of D alloimmunization and data from some recent large studies, we recommend administering Rh Immune Globulin, if D-mismatched platelet concentrates prepared from whole blood collections are transfused to D negative females of childbearing potential.
PURPOSE OF REVIEW: Current guidance allows transfusing D-mismatched platelets to D negative recipients when necessitated by logistic constraints. Although the D antigen is not expressed on the platelet membrane, platelet concentrates are still labeled by their D antigen status because the platelet concentrates contain a small quantity of red blood cells. D matching is currently recommended to prevent D alloimmunization based on frequencies of D alloimmunization after transfusing platelet concentrates obtained from whole blood collections of up to 18.7%. RECENT FINDINGS: The content of red blood cells is higher in pooled platelet concentrates prepared from whole blood collections (range: 0.036-0.59 ml) than in platelet concentrates obtained from apheresis devices (range: 0.00017-0.009 ml). Large retrospective studies with long follow-up suggest that it is not possible to rule out a secondary immunization in D negative patients who developed an alloanti-D within 4 weeks after receiving the first D-mismatched platelet transfusion, and the frequency of D alloimmunization after D-mismatched platelet transfusions ranges between 0 and 7.1%. SUMMARY: Based on the reported frequencies of D alloimmunization and data from some recent large studies, we recommend administering Rh Immune Globulin, if D-mismatched platelet concentrates prepared from whole blood collections are transfused to D negative females of childbearing potential.
Authors: Johanna Reckhaus; Markus Jutzi; Stefano Fontana; Vera Ulrike Bacher; Marco Vogt; Michael Daslakis; Behrouz Mansouri Taleghani Journal: Transfus Med Hemother Date: 2018-05-24 Impact factor: 3.747
Authors: Louis Thibault; Marie Joëlle de Grandmont; Marie-Pierre Cayer; Nathalie Dussault; Annie Jacques; Eric Ducas; Annie Beauséjour; André Lebrun Journal: Transfus Med Hemother Date: 2019-06-27 Impact factor: 3.747