Anti‐D alloimmunization after D‐incompatible platelet transfusions: a 14‐year single‐institution retrospective review. Issue 3 (7th July 2013)

• Record Type: Journal Article
• Authors: O'Brien, Kerry L.; Haspel, Richard L.; Uhl, Lynne
• Is Part Of: Transfusion. Volume 54:Issue 3(2014)
• Page Start: 650
• Page End: 654
• Publication Date: 2013-07-07
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.12341
• Languages: English
• ISSNs: 0041-1132

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="trf12341-sec-0001" sec-type="section"> <title>Background</title> <p>A small, but immunogenic dose of red blood cells (RBCs) may be contained in apheresis platelets (PLTs). Attempts are made to provide D− recipients with D− PLTs to prevent anti‐D alloimmunization and the potential for hemolytic disease of the fetus and newborn. Beth Israel Deaconess Medical Center has a policy that when necessary to transfuse D+ PLTs to D− patients, we recommend that RhIG be given when the patient is a woman of child‐bearing age or a potential liver transplant patient. We sought to retrospectively determine the rate of anti‐D formation after D‐incompatible apheresis PLT transfusions in those patients not receiving RhIG and not receiving D+ RBCs over a 14‐year period at our institution.</p> </sec> <sec id="trf12341-sec-0002" sec-type="section"> <title>Study Design and Methods</title> <p>All D− patients (626) who received D+ prestorage leukoreduced apheresis PLTs between January 1, 1997, and December 31, 2011, were identified. Those patients who received RhIG (45), D+ RBC transfusions (50), or stem cell transplantation from a D+ donor (16); had prior anti‐D (23); or had unresolved Rh at admission (8) were not eligible for analysis. Only those patients who had an antibody screen performed at least 4 weeks after the incipient PLT transfusion were evaluated (130).</p> </sec> <sec id="trf12341-sec-0003" sec-type="section"> <title>Results</title> <p>Of 130 eligible D− patients, 48% women and 57% immunocompetent, who received a total of 565 apheresis PLTs, none formed anti‐D.</p> </sec> <sec id="trf12341-sec-0004" sec-type="section"> <title>Conclusion</title> <p>These findings support the use of D+ apheresis PLTs without RhIG irrespective of D status in all recipients.</p> </sec> </abstract>