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Updated: Jul 2, 2025
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Routine Screening Method for Microparticles in Platelet Transfusions
Published on: January 31, 2018
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ABO non-identical platelet transfusions, immune platelet refractoriness and platelet support
Min-Hi Han1,2, Krishna Govind Badami2
1Department of Haematology, Christchurch Hospital, Christchurch, New Zealand.
British Journal of Haematology
|February 29, 2024
Summary
ABO-non-identical (ABO-ni) platelets increase the risk of immune platelet transfusion refractoriness (i-PTR). Patients receiving more ABO-ni platelets experienced i-PTR and required longer support with matched platelets.
Area of Science:
- Transfusion Medicine
- Immunology
- Hematology
Background:
- Immune platelet transfusion refractoriness (i-PTR) poses a significant challenge in patient care.
- ABO-non-identical (ABO-ni) platelet transfusions are suspected risk factors for i-PTR.
Purpose of the Study:
- To investigate the impact of ABO-ni platelets on the incidence of i-PTR.
- To identify independent risk factors for i-PTR.
- To assess the effect of ABO-ni platelet exposure on subsequent platelet support.
Main Methods:
- Retrospective analysis of 17,322 patients receiving platelet transfusions.
- Definition of i-PTR as refractoriness with anti-HLA-I/HPA positivity.
- Univariate and multivariate analyses to determine independent risk factors.
Main Results:
- 1.1% of patients (188) developed i-PTR.
- Patients with i-PTR received significantly more ABO-ni platelets (53.2%) compared to non-refractory patients (29.5%).
- Independent risk factors for i-PTR included female sex, age ≤60 years, hematology diagnoses, and receiving ≥2 ABO-ni platelets.
- i-PTR patients exposed to ABO-ni platelets required matched platelets for a longer duration (96.5 days) than those receiving only ABO-identical platelets (59.0 days).
Conclusions:
- ABO-ni platelets are a significant risk factor for developing i-PTR, with a potential dose-dependent effect.
- Consideration of ABO-identical (ABO-i) platelets is recommended for patients at risk of i-PTR.
- Understanding these factors can optimize platelet transfusion strategies and improve patient outcomes.
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