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Current trends in platelet transfusions practice: The role of ABO-RhD and human leukocyte antigen incompatibility
Platelet transfusions have contributed to the revolutionary modern treatment of hypoproliferative thrombocytopenia. Despite the long-term application of platelet transfusion in therapeutics, all aspects of their optimal use (i.e., in cases of ABO and/or Rh (D incompatibility) have not been definitiv...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562128/ https://www.ncbi.nlm.nih.gov/pubmed/26420927 http://dx.doi.org/10.4103/0973-6247.162684 |
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author | Valsami, Serena Dimitroulis, Dimitrios Gialeraki, Argyri Chimonidou, Maria Politou, Marianna |
author_facet | Valsami, Serena Dimitroulis, Dimitrios Gialeraki, Argyri Chimonidou, Maria Politou, Marianna |
author_sort | Valsami, Serena |
collection | PubMed |
description | Platelet transfusions have contributed to the revolutionary modern treatment of hypoproliferative thrombocytopenia. Despite the long-term application of platelet transfusion in therapeutics, all aspects of their optimal use (i.e., in cases of ABO and/or Rh (D incompatibility) have not been definitively determined yet. We reviewed the available data on transfusion practices and outcome in ABO and RhD incompatibility and platelet refractoriness due to anti-human leukocyte antigen (HLA) antibodies. Transfusion of platelets with major ABO-incompatibility is related to reduced posttransfusion platelet (PLT) count increments, compared to ABO-identical and minor, but still are equally effective in preventing clinical bleeding. ABO-minor incompatible transfusions pose the risk of an acute hemolytic reaction of the recipient that is not always related to high anti-A, B donor titers. ABO-identical PLT transfusion seems to be the most effective and safest therapeutic strategy. Exclusive ABO-identical platelet transfusion policy could be feasible, but alternative approaches could facilitate platelet inventory management. Transfusion of platelets from RhD positive donors to RhD negative patients is considered to be effective and safe though is associated with low rate of anti-D alloimmunization due to contaminating red blood cells. The prevention of D alloimmunization is recommended only for women of childbearing age. HLA alloimmunization is a major cause of platelet refractoriness. Managing patients with refractoriness with cross-matched or HLA-matched platelets is the current practice although data are still lacking for the efficacy of this practice in terms of clinical outcome. Leukoreduction contributes to the reduction of both HLA and anti-D alloimmunization. |
format | Online Article Text |
id | pubmed-4562128 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-45621282015-09-29 Current trends in platelet transfusions practice: The role of ABO-RhD and human leukocyte antigen incompatibility Valsami, Serena Dimitroulis, Dimitrios Gialeraki, Argyri Chimonidou, Maria Politou, Marianna Asian J Transfus Sci Review Article Platelet transfusions have contributed to the revolutionary modern treatment of hypoproliferative thrombocytopenia. Despite the long-term application of platelet transfusion in therapeutics, all aspects of their optimal use (i.e., in cases of ABO and/or Rh (D incompatibility) have not been definitively determined yet. We reviewed the available data on transfusion practices and outcome in ABO and RhD incompatibility and platelet refractoriness due to anti-human leukocyte antigen (HLA) antibodies. Transfusion of platelets with major ABO-incompatibility is related to reduced posttransfusion platelet (PLT) count increments, compared to ABO-identical and minor, but still are equally effective in preventing clinical bleeding. ABO-minor incompatible transfusions pose the risk of an acute hemolytic reaction of the recipient that is not always related to high anti-A, B donor titers. ABO-identical PLT transfusion seems to be the most effective and safest therapeutic strategy. Exclusive ABO-identical platelet transfusion policy could be feasible, but alternative approaches could facilitate platelet inventory management. Transfusion of platelets from RhD positive donors to RhD negative patients is considered to be effective and safe though is associated with low rate of anti-D alloimmunization due to contaminating red blood cells. The prevention of D alloimmunization is recommended only for women of childbearing age. HLA alloimmunization is a major cause of platelet refractoriness. Managing patients with refractoriness with cross-matched or HLA-matched platelets is the current practice although data are still lacking for the efficacy of this practice in terms of clinical outcome. Leukoreduction contributes to the reduction of both HLA and anti-D alloimmunization. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4562128/ /pubmed/26420927 http://dx.doi.org/10.4103/0973-6247.162684 Text en Copyright: © Asian Journal of Transfusion Science http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Valsami, Serena Dimitroulis, Dimitrios Gialeraki, Argyri Chimonidou, Maria Politou, Marianna Current trends in platelet transfusions practice: The role of ABO-RhD and human leukocyte antigen incompatibility |
title | Current trends in platelet transfusions practice: The role of ABO-RhD and human leukocyte antigen incompatibility |
title_full | Current trends in platelet transfusions practice: The role of ABO-RhD and human leukocyte antigen incompatibility |
title_fullStr | Current trends in platelet transfusions practice: The role of ABO-RhD and human leukocyte antigen incompatibility |
title_full_unstemmed | Current trends in platelet transfusions practice: The role of ABO-RhD and human leukocyte antigen incompatibility |
title_short | Current trends in platelet transfusions practice: The role of ABO-RhD and human leukocyte antigen incompatibility |
title_sort | current trends in platelet transfusions practice: the role of abo-rhd and human leukocyte antigen incompatibility |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562128/ https://www.ncbi.nlm.nih.gov/pubmed/26420927 http://dx.doi.org/10.4103/0973-6247.162684 |
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