Anti-D immunization after D positive platelet transfusions in D negative recipients: A systematic review and meta-analysis.
Transfusion
; 64(5): 933-945, 2024 May.
Article
en En
| MEDLINE
| ID: mdl-38634345
ABSTRACT
BACKGROUND:
Anti-D can be formed after D-incompatible platelet transfusions due to contaminating D+ red blood cells. These antibodies are of particular importance in women of childbearing potential, because anti-D is most often involved in severe cases of hemolytic disease of the fetus and newborn. This systematic review determined the frequency of anti-D after D+ platelet transfusions and risk factors for D alloimmunization. STUDY DESIGN ANDMETHODS:
Relevant literature was searched using PubMed, Embase and Web of Science until December 2022. Overall anti-D frequency and risk factors were estimated using a random effects meta-analysis.RESULTS:
In 22 studies, a total of 3028 D- patients received a mean of six D+ platelet transfusions. After a mean follow-up of seven months 106 of 2808 eligible patients formed anti-D. The pooled anti-D frequency was 3.3% (95% CI 2.0-5.0%; I2 71%). After including only patients with an undoubtable follow-up of at least 4 weeks, 29 of 1497 patients formed anti-D with a pooled primary anti-D rate of 1.9% (95% CI 0.9-3.2%, I2 44%). Women and patients receiving whole blood derived platelets had two and five times higher anti-D rates compared with men and patients receiving apheresis derived platelets, respectively.DISCUSSION:
Anti-D immunization is low after D incompatible platelet transfusions and dependent on recipients' sex and platelet source. We propose anti-D prophylaxis in girls and women, capable of becoming pregnant in the future, that received D+ platelets, regardless of platelet source, to reduce the risk of anti-D induced hemolytic disease of the fetus and newborn.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Globulina Inmune rho(D)
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Transfusión de Plaquetas
Límite:
Female
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Humans
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Pregnancy
Idioma:
En
Revista:
Transfusion
Año:
2024
Tipo del documento:
Article
País de afiliación:
Países Bajos