ABO compatibility and platelet transfusions of alloimmunized thrombocytopenic patients

Duguesnoy, RJ; Anderson, A. J.; Pa, Tomasulo; Aster, RH

doi:10.1182/blood.v54.3.595.bloodjournal543595

Blood

1979

DOI: 10.1182/blood.v54.3.595.bloodjournal543595

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ABO compatibility and platelet transfusions of alloimmunized thrombocytopenic patients

RJ Duguesnoy¹,

A. J. Anderson²,

Tomasulo Pa³

et al.

Abstract: With data on 91 alloimmunized thrombocytopenic patients and 389 donor- recipient pairs matched or selectively mismatched for HLA antigens, it was observed that ABO incompatibility significantly reduced the effectiveness of platelet transfusions. The mean 24-hr recovery of platelets from histocompatible donors and from donors selectively mismatched for cross-reactive HLA antigens was decreased by approximately 23% if the donor typed for blood group A and/or B not found in the recipient. Thus, the reduction in p… Show more

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Cited by 4 publications

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Platelets: New Understanding of Platelet Glycoproteins and Their Role in Disease

Bussel¹,

Kunicki²,

Michelson³

2000

Hematology

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This review covers new developments and their clinical implications in three areas: platelet antigen polymorphisms, inhibition of platelet glycoprotein IIb-IIIa, and autoimmune thrombocytopenia (ITP).In Section I, Dr. Kunicki reviews platelet polymorphisms and their clinical implications. A current tabulation of the numerous platelet antigens, both those that are platelet specific and not platelet specific, are summarized. The immunogenic clinical implications of these polymorphisms are considered, including fetal and neonatal alloimmune thrombocytopenia, post transfusion purpura, and refractoriness to platelet transfusion. The functional relationship to hemostasis and thrombosis is also discussed, in particular whether one haplotype of the PIA1/PIA2 (HPA-1a/1b) polymorphism predisposes to myocardial infarction. Finally, novel investigations of polymorphisms will be considered, including hormonal induction of certain polymorphisms.In Section II, Dr. Michelson reviews the newest generation of platelet inhibitors, those blocking glycoprotein IIB/IIIA, from the point of view of the hematologist who might be consulted about a patient receiving this form of treatment. The current use of available IIb-IIIa inhibitors and those in trial and the accepted and possible future indications for their use are addressed. The mechanism of action and actual and theoretical advantages and disadvantages of each inhibitor are explored. Scenarios that prompt consultation with a hematologist are presented, including management of bleeding, thrombocytopenia, and management of the patient requiring emergency surgery.In Section III, Dr. Bussel reviews controversies in ITP, looking at both the current state of the art and the potential for the future. Case presentations are used to illustrate the issues in both children and adults. Three primary areas are addressed: 1) the diagnosis of ITP, 2) when and for which patient to recommend splenectomy, and 3) the management of the refractory splenectomized patient who still has a low platelet count and bleeding symptoms.

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Platelets: New Understanding of Platelet Glycoproteins and Their Role in Disease

Bussel¹,

Kunicki²,

Michelson³

2000

Hematology

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ABO and platelet transfusion therapy

Cooling

2007

Immunohematology

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Review: platelet immunology—similarities and differences with red cell immunology

Garratty

1995

Immunohematology

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In many ways platelet and red blood cell (RBC) immunology are similar, but there are important differences. At least 272 RBC antigens have been described. These have been placed into 22 systems (194 antigens), 7 collections (20 antigens), and 2 series (high-frequency antigens [12] and low-frequency antigens [46])1. Platelets express human leukocyte antigens (HLA) (class 1 only), ABH, P (not P1), Lewis, I, and platelet-specific antigens on their membranes. Platelet-specific antigens can be classified into five biallelic systems, originally called PlA1 (Zw), Ko(Sib), Bak, Yuk (Pen), and Br. Each system includes a high-frequency antigen occurring in 96 percent to >99 percent of the population, and homozygosity for a lower-frequency antigen, occurring in 4 percent to <1 percent of the population. In addition, a number of additional low-frequency (private) antigens (e.g., Moa, Caa, Sra, Vaa, Iya, Pea, Groa, Maxa) have been described.2−4 Like RBC antigens and antibodies, platelet-specific antigens and antibodies were first named using letters from the name of the propositus (e.g., Bak, Br, Yuk).

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ABO compatibility and platelet transfusions of alloimmunized thrombocytopenic patients

Cited by 4 publications

References 0 publications

Platelets: New Understanding of Platelet Glycoproteins and Their Role in Disease

Platelets: New Understanding of Platelet Glycoproteins and Their Role in Disease

ABO and platelet transfusion therapy

Review: platelet immunology—similarities and differences with red cell immunology

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