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Routine Screening Method for Microparticles in Platelet Transfusions
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D+ platelet transfusions in D- patients: cause for concern?

A N Bartley1, J B Carpenter, M P Berg

  • 1Department of Pathology, Tucson, AZ 85724-508, USA.

Immunohematology
|October 28, 2009
PubMed
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Patients with D- red blood cells (RBCs) can safely receive D+ platelets without risk of anti-D alloimmunization. Transfusion guidelines for D- patients do not need to restrict platelet sources, and Rh immunoglobulin (RhIG) appears unnecessary.

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Area of Science:

  • Immunology
  • Transfusion Medicine
  • Hematology

Background:

  • Patients with D- red blood cells (RBCs) may develop anti-D antibodies upon exposure to D+ RBCs.
  • Platelets lack Rh antigens, but contamination with D+ RBCs can occur during collection.
  • Current practice often restricts D- patients to D- RBCs and apheresis platelets, with potential Rh immunoglobulin (RhIG) use.

Purpose of the Study:

  • To investigate D alloimmunization in D- patients receiving D+ platelets without RhIG prophylaxis.
  • To evaluate the safety and efficacy of transfusing D+ platelets to D- recipients.

Main Methods:

  • Retrospective review of transfusion records from December 2004 to March 2007.
  • Analysis of 114 D- patients who received platelet transfusions.
  • Pre- and post-transfusion ABO/D typing and antibody screening.

Main Results:

  • 104 D- patients received D+ platelets; 67 had follow-up antibody screening.
  • No instances of anti-D alloimmunization were observed in D- patients after D+ platelet transfusion.
  • No evidence of D alloimmunization occurred in any D- patient during the study period.

Conclusions:

  • Transfusion of D+ platelets to D- patients does not appear to cause D alloimmunization.
  • Restrictions on apheresis platelet sources for D- patients are not supported by these findings.
  • Prophylactic RhIG is likely unnecessary for D- patients receiving D+ apheresis platelets.