Premium
Platelet transfusions from D+ donors to D− patients: a 10‐year follow‐up study of 1014 patients
Author(s) -
Cid Joan,
Carbassé Gloria,
Pereira Arturo,
Sanz Cristina,
Mazzara Roberto,
Escolar Ginés,
Lozano Miguel
Publication year - 2011
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2010.02953.x
Subject(s) - medicine , apheresis , incidence (geometry) , platelet , blood transfusion , isoantibodies , platelet transfusion , surgery , pediatrics , antibody , immunology , physics , optics
BACKGROUND: Current guidelines recommend that platelets (PLTs) from D− donors should be given to D− patients. However, such evidence comes from studies with a limited number of included patients that reported an incidence of anti‐D alloimmunization to be up to 19%. We thus decided to extend these findings by examining anti‐D alloimmunization at our institution, where PLT transfusions from D+ donors are transfused to D− patients because of logistic constraints. STUDY DESIGN AND METHODS: From April 1999 to December 2009, we retrospectively reviewed the clinical and transfusion records of all D− patients who received PLT transfusions from D+ donors at our hospital. PLT concentrates (PCs) were obtained from apheresis and from whole blood donations. RhIG was not administered after the transfusion of PCs from D+ donors. The antibody screen test to detect anti‐D was performed by low‐ionic‐strength solution indirect antiglobulin test using the gel test. RESULTS: Our series comprises 1014 D− patients who received 5128 PLT transfusions from D+ donors (89% were pooled PCs). We had 315 (31.1%) patients who had a blood sample to analyze the presence of anti‐D 4 or more weeks after the first D+ PLT transfusion with a median follow‐up of 29 weeks (range, 4‐718 weeks). Anti‐D developed in 12 (3.8%) of these 315 patients. CONCLUSIONS: The frequency of anti‐D alloimmunization of D− patients after receiving pooled PCs from D+ donors is low. The transfusion of D‐incompatible pooled PCs without immunoprophylaxis to D− men or D− women without childbearing potential seems a reasonable and safe alternative.