Factors that influence platelet recovery after transfusion: resolving donor quality from ABO compatibility

Abstract

When transfusions of platelets are ABO-identical, donor quality dominates recovery in circulation. Donor quality is predicted by a rapid and simple assay of citrate-induced microaggregation performed at the time of apheresis. When donor quality is factored out, ABO identity prevails.

Role of ABO and Rh Type in Platelet Transfusion

“…Slichter and colleagues 20 demonstrated that the most important characteristic affecting CCI was ABO compatibility with product age and irradiation of the product playing a lesser, but still significant, role. In concordance with studies of healthy volunteers, Jimenez and associates 21 found that ABO major incompatible platelet transfusions yielded one-third the platelet recovery of ABO identical transfusions.…”

Determinants of ABH expression on human blood platelets

“…Transfusion of ABH-incompatible platelets, even in the presence of HLA matching, can be associated with a decrease in the posttransfusion corrected count increment, [8][9][10][11]17 increased platelet utilization, 12,44 incompatible platelet crossmatches, 11,14 HLA alloimmunization, 12,13,44 and ABH-specific refractoriness. [8][9][10][11]16,18,23,24 The impact of ABH incompatibility is determined by patient and donor factors, including the type of ABH mismatch and recipient isohemagglutinin titers. 8,9,[16][17][18] Overall, clinical ABH incompatibility is most commonly observed with group A platelets transfused to group O patients, due to increased antigenicity of the A antigen and higher mean anti-A titers.…”

“…[2][3][4][5][6][7][8] Clinically, transfusion of ABHincompatible platelets can be associated with decreased recovery, [8][9][10][11] shortened survival, 10 and an increased incidence and onset of HLA-immune refractoriness. [11][12][13] ABH incompatibility can lead to positive platelet crossmatches, 14 acting synergistically with HLA incompatibility to further decrease posttransfusion recovery and survival.…”

Extended Small-Dose Platelet Transfusions in Multitransfused Hemato-Oncological Patients: A Single-Center Experience

“…The most frequently encountered causes include sepsis, viremia, disseminated intravascular coagulation and medications known to interfere with platelet survival [5,13]. These nonimmune factors are addressed by treating the cause.…”