Isohemagglutinin titration in pooled and apheresis platelets.
Transfusion
; 64(7): 1279-1286, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38795022
ABSTRACT
BACKGROUND:
Platelet inventory constraints necessitate ABO-incompatible platelet transfusion. Many minimize the hemolytic impact by confirming low titre (LT) donor isohemagglutinins. This process is costly. Pathogen-reduced platelets (PRP) in platelet additive solutions (PAS) will dilute plasma and decrease high-titre isohemagglutinins (HT). We determined the proportion of HT platelets and incompatible transfusions for units suspended in plasma to reassess the need for titres following introduction of PRP/PAS. STUDY DESIGN ANDMETHODS:
Our titre method is manual tube (150) dilution of platelet supernatant from apheresis or whole blood derived buffy coat pools suspended in plasma, tested with A1/B red cells. Testing included 49,058 pooled and 11,738 apheresis platelets over 4 years. The HT proportion, rate of out-of-group transfusions, and hemolytic reactions were determined. The impact of PAS dilution was estimated.RESULTS:
Totally 60,796 platelet units were tested. Group O pooled and group B apheresis platelets had HT in 6.6% and 5.7%, respectively. Group A pooled and apheresis platelets included 2% with HT. Approximately 25% of platelets transfused were ABO-incompatible and no hemolytic reactions were reported. Based on the proportions of PAS-E and plasma for PRP platelets, plasma from each donor comprises 11 mL (6% of total volume) vs 20-257 mL in untreated pools. PAS-E will replace and dilute residual plasma by at least 50%.DISCUSSION:
Rare platelet pools may demonstrate HT. PRP platelets with PAS will reduce titres and may abrogate the need for titration. A strategy of group specific transfusion or transfusion of group A PRP platelet transfusions may be a safe alternative.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Plaquetas
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Sistema ABO de Grupos Sanguíneos
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Plaquetoferese
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Transfusão de Plaquetas
Limite:
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article