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Response to random apheresis platelets versus HLA‐selected platelets versus pooled platelets in HLA‐sensitized patients
Author(s) -
Gavva Chakri,
Barroso Jeffrey,
Gernsheimer Terry,
Metcalf Ryan A.,
Warner Paul,
Pagano Monica B.
Publication year - 2019
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/trf.15333
Subject(s) - apheresis , platelet , medicine , human leukocyte antigen , significant difference , plateletpheresis , platelet transfusion , immunology , antigen
BACKGROUND It is unknown how pooled platelets (PPs) compare to random apheresis platelets (RAPs) when HLA‐selected platelets (PLTs) are unavailable for HLA‐sensitized patients. The aim of this study was to compare patient responses to RAPs, HLA‐selected PLTs, and PPs in HLA‐sensitized patients. STUDY DESIGN AND METHODS This is a single‐institution retrospective study of patients from January 2014 to April 2017 with a class I calculated panel‐reactive antibody of 60% or more. Response to transfusion was determined by a corrected count increment (CCI) up to 1 hour after completion of transfusion. A CCI of 5 or more was considered successful. RESULTS Seventy‐seven units of RAPs, 412 units of HLA‐selected PLT, and 388 units PPs were transfused. Mean CCIs when transfusing RAPs, HLA‐selected PLTs, and PPs were 2.82, 11.44, and 4.77, respectively (p < 0.0001). Posttest comparison between RAPs and PPs revealed no significant difference in mean CCI while there was a significant difference between HLA‐selected PLTs versus RAPs and HLA‐selected PLTs versus PPs. The success rates of RAPs, HLA‐selected PLTs, and PPs were 31%, 80%, and 35% respectively. There was no significant association of type of PLT and success rate when comparing RAPs versus PPs (p = 0.51) while there was a significant association between success rate and type of PLT transfusion when comparing HLA‐selected PLTs with RAPs and PPs. CONCLUSION HLA‐selected PLTs resulted in higher mean CCIs and more successful transfusions. There was no significant difference in mean CCI or success rate when transfusing RAPs versus PPs to HLA‐sensitized patients. Future studies should assess clinical outcomes in HLA‐sensitized patients receiving each type of PLT product.