Prospective surveillance of D- recipients of D+ apheresis platelets: alloimmunization against D is not detected.

Abstract:

BACKGROUND:Recent retrospective studies indicate that D- recipients of D+ apheresis platelets (PLTs) are not alloimmunized to D. Our hospital policy is to offer RhIG to D- women of childbearing age who received D+ apheresis PLTs but not to other D- recipients of D+ apheresis PLTs. We instituted prospective surveillance of the D- recipients who were not given RhIG. STUDY DESIGN AND METHODS:All apheresis PLT recipients were prospectively entered into a database that recorded the patient's age, sex, diagnosis, D status, apheresis PLT transfusions, and antibody screen results from before and after PLT transfusions. Data are reported for PLTs transfused between October 16, 2012, and April 16, 2014, and antibody screens obtained through June 16, 2014. The analysis excludes neonates; women not more than 50 years of age; and patients who also received D+ red blood cells, received only D- PLTs, received RhIG, were previously alloimmunized to D, and did not have a follow-up antibody screen after the first D-incompatible apheresis PLT transfusion. RESULTS:A total of 158 of 1107 apheresis PLT recipients were D-. Seventy-nine were eligible for analysis based on the exclusion criteria listed above. None became alloimmunized to D during the observation interval. In 45 (57%) cases the last follow-up antibody screen was obtained at least 4 weeks after the first D-incompatible apheresis PLT transfusion. CONCLUSION:Prospective surveillance confirms prior retrospective observations that D- patients do not appear to risk D alloimmunization after receiving D+ apheresis PLTs.

journal_name

Transfusion

journal_title

Transfusion

authors

Weinstein R,Simard A,Ferschke J,Vauthrin M,Bailey JA,Greene M

doi

10.1111/trf.12972

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

1327-30

issue

6

eissn

0041-1132

issn

1537-2995

journal_volume

55

pub_type

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