Absence of anti‐D alloimmunization in hematologic patients after D‐incompatible platelet transfusions

Cid, Joan; Ortı́n, Xavier; Elies, Enric; Castellà, Dolors; Panadés, M; Martín‐Vega, Carmen

doi:10.1046/j.1537-2995.2002.00038.x

Cited by 52 publications

(52 citation statements)

References 17 publications

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“…If we exclude those patients, the percentage of D alloimmunization varies as shown in table 3. Overall, the incidence of D alloimmunization in immunosuppressed patients after D incompatible platelet transfusions is reported to be between 0 and 19% [83,84,85,86,87,88,89,90,91,92,93,94], but keeping some recently published data in mind [95], we can conclude that the frequency of anti-D alloimmunization actually ranges between 0 and 6.8% [96]. …”

Section: Part 2: Plt Transfusion and The D Antigenmentioning

confidence: 95%

“…These authors reported an anti-D alloimmunization frequency of 13.5% in a group of 59 patients with non-hematological diseases after a median follow-up of 38 weeks (range 2-133 weeks). Cid et al [91,92] reported no anti-D formation in 22 D- patients with hematological diseases who received D+ PLTs after a median follow-up of 8 weeks (range 1-37 weeks). Of note, 41% of the patients did not survive beyond 7 weeks.…”

Section: Part 2: Plt Transfusion and The D Antigenmentioning

confidence: 99%

“…In some of the reports on D alloimmunization after D incompatible PLT transfusion, the percentage of ABO incompatible transfusions is provided; it ranges between 43 and 90% (table 3) [84,87,88,91,93,95]. Thus, the protective effect associated with the transfusion of ABO and D mismatched RBCs is unlikely to be seen in current clinical practice given the high incidence of ABO matched transfusions in the studies reported [99].…”

Section: Part 2: Plt Transfusion and The D Antigenmentioning

confidence: 99%

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Platelet Transfusion - the Art and Science of Compromise

Cid

Harm

Yazer

2013

Transfus Med Hemother

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Many modern therapies depend on platelet (PLT) transfusion support. PLTs have a 4- to 7-day shelf life and are frequently in short supply. In order to optimize the inventory PLTs are often transfused to adults without regard for ABO compatibility. Hemolytic reactions are infrequent despite the presence of ‘high titer' anti-A and anti-B antibodies in some of the units. Despite the low risk for hemolysis, some centers provide only ABO identical PLTs to their recipients; this practice might have other beneficial outcomes that remain to be proven. Strategies to mitigate the risk of hemolysis and the clinical and laboratory outcomes following ABO-matched and mismatched transfusions will be discussed. Although the PLTs themselves do not carry the D antigen, a small number of RBCs are also transfused with every PLT dose. The quantity of RBCs varies by the type of PLT preparation, and even a small quantity of D+ RBCs can alloimmunize a susceptible D- host. Thus PLT units are labeled as D+/-, and most transfusion services try to prevent the transfusion of D+ PLTs to D- females of childbearing age. A similar policy for patients with hematological diseases is controversial, and the elements and mechanisms of anti-D alloimmunization will be discussed.

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Section: Part 2: Plt Transfusion and The D Antigenmentioning

confidence: 95%

Section: Part 2: Plt Transfusion and The D Antigenmentioning

confidence: 99%

Section: Part 2: Plt Transfusion and The D Antigenmentioning

confidence: 99%

See 1 more Smart Citation

Platelet Transfusion - the Art and Science of Compromise

Cid

Harm

Yazer

2013

Transfus Med Hemother

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“…Recent reports suggest that random donor platelets contain 0.30 to 0.59 mL of red cells per unit. 27,28 Similar studies report the red cell content of apheresis platelets as less than 0.005 mL per unit. 27,29 The amount of Rh positive red cells necessary to sensitize an individual has not been precisely determined.…”

Section: Rh Incompatibilitymentioning

confidence: 86%

Role of ABO and Rh Type in Platelet Transfusion

Holland

2006

Laboratory Medicine

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“…21 Conversely, other authors found a low incidence of anti-D alloimmunization in hematologic patients receiving D-incompatible platelet transfusions. [22][23][24] A BMT recipient with a pre-existing anti-RhD alloantibody must be transfused with RhD-negative RBC until the disappearance of the alloantibody has been documented by the indirect antiglobulin test (IAT) and the cross-match with RhD-positive RBC becomes negative. 9 Alloantibodies directed against other components of the Rh system include anti-C, anti-c and anti-E antibodies.…”

Section: Incompatibility Involving the Rh Systemmentioning

confidence: 99%

Non-ABO red blood cell alloantibodies following allogeneic hematopoietic stem cell transplantation

Franchini

Gandini

Aprili

2004

Bone Marrow Transplant

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Summary:Immune-mediated hemolysis is a well-recognized occurrence which complicates the period following a bone marrow transplant (BMT). However, although many studies have investigated the hemolytic anemia following ABO-incompatible BMT, data regarding the occurrence of alloantibodies against red blood cell (RBC) antigens other than ABO in patients undergoing hematopoietic stem cell transplantation are limited. In this review, we briefly analyze the most important non-ABO red blood cell (RBC) antigen systems involved in the development of post-BMT alloimmune hemolytic anemia, paying particular attention to the pathogenic mechanisms and the clinical significance of the alloantibodies involved. Among the non-ABO RBC antigens, RhD antigen is the one most frequently implicated in the development of post-BMT alloimmune hemolytic anemia. Although less frequent than hemolysis following transplants with ABO incompatibility, non-ABO-incompatible allograft hemolysis may severely complicate the post-BMT period creating difficult clinical management issues. For this reason, we advise careful pre-transplant donor and recipient checks for the most important RBC antigen systems and close post-BMT immunohematological monitoring in those patients undergoing allogeneic hematopoietic stem cell transplant with RBC antigen incompatibility.

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Absence of anti‐D alloimmunization in hematologic patients after D‐incompatible platelet transfusions

Abstract: The risk of D alloimmunization is low in patients with hematologic disease after D-incompatible platelet transfusions using platelet concentrates prepared by the buffy coat method.

Cited by 52 publications

References 17 publications

Platelet Transfusion - the Art and Science of Compromise

Platelet Transfusion - the Art and Science of Compromise

Role of ABO and Rh Type in Platelet Transfusion

Non-ABO red blood cell alloantibodies following allogeneic hematopoietic stem cell transplantation

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