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Routine Screening Method for Microparticles in Platelet Transfusions
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ABO-incompatible platelets are associated with increased transfusion reaction rates
Natalie Malvik1, Judith Leon1, Annette J Schlueter1
1DeGowin Blood Center, Department of Pathology, University of Iowa Hospitals & Clinics, Iowa City, Iowa.
Transfusion
|January 9, 2020
Summary
ABO incompatible platelets increase transfusion reaction risks, with major antigen-incompatible transfusions showing the highest rates. Compatible platelet transfusions remain the safest option, demonstrating the importance of ABO matching for patient safety.
Area of Science:
- Hematology
- Transfusion Medicine
- Immunology
Background:
- ABO compatibility is crucial for platelet transfusion safety and efficacy.
- ABO-incompatible (ABOi) platelets may increase transfusion reaction risks, but the extent is not well-defined.
Purpose of the Study:
- To quantify the risk of transfusion reactions associated with ABOi platelets compared to ABO-compatible platelets.
- To analyze the impact of different ABO incompatibility types on transfusion reaction rates.
Main Methods:
- Retrospective analysis of platelet transfusion data over 36+ months.
- Classification of transfusions by patient and product ABO blood group.
- Merging transfusion data with reported transfusion reactions to calculate reaction rates.
Main Results:
- ABOi platelet transfusions in patients >1 year old had a 1.7% reaction rate versus 1.0% for ABO-compatible (ABO-identical) platelets.
- Major ABO antigen-incompatible transfusions exhibited the highest reaction rate (2.0%).
- Acute hemolytic reactions were rare (0.12%) in plasma-incompatible transfusions.
Conclusions:
- Compatible platelet transfusions are associated with the lowest transfusion reaction rates.
- ABO antigen-incompatible platelet transfusions carry the highest risk, 1.5 to 2 times that of compatible transfusions.
- While rare, hemolytic reactions can occur with plasma-incompatible platelet transfusions.
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