Prospective surveillance of <scp>D</scp>− recipients of <scp>D</scp>+ apheresis platelets: alloimmunization against <scp>D</scp> is not detected

Weinstein, Robert S.; Simard, Amie; Ferschke, Jillian; Vauthrin, Michelle; Bailey, Jeffrey A.; Greene, Mindy

doi:10.1111/trf.12972

Cited by 25 publications

(14 citation statements)

References 23 publications

(52 reference statements)

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“…In the present study, out of 332 D‐negative patients received D‐positive platelets who were analysed for the formation of anti‐D, only three patients developed anti‐D. This rate of 0·9% alloimmunization was similar to many recent published studies .…”

Section: Discussionsupporting

confidence: 90%

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Practice of transfusing D‐positive platelets in D‐negative recipients – a reappraisal (POINT‐R)

Dara

Tiwari

Arora

et al. 2015

ISBT Science Series

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Background Many centres provide D-mismatched platelet transfusions. Platelet concentrates may contain enough red cells leading to the formation of anti-D antibody in D-negative recipient. In resource-poor settings, random donor platelet concentrate (RDPC) is used often and carries higher risk of alloimmunization. At our institution, platelets are transfused across the ABO and Rh blood group barrier without any RhIG immunoprophylaxis. In this study, we retrospectively appraised alloimmunization after D-positive platelet transfusion in D-negative patients. Materials and MethodsSingle-centre 5-year data were collected from Hospital Information System (HIS) for D-negative patients who received D-positive platelet transfusions. Naive patients who had neither pre-existing antibody nor received D-positive platelet transfusion before admission were included. Those who had repeat antibody screening at least 28 days after D-positive platelet transfusion were considered.Results A total of 332 D-negative patients who received 1996 D-positive platelet transfusions were analysed. Median follow-up was 7 weeks (range = 4-90). Anti-D was detected in three (0Á9%) D-negative patients at 5, 8 and 24 weeks after receiving D-positive platelet transfusions. Two of these patients received RDPCs and one received both RDPCs and single donor platelet concentrates.Conclusion D-positive platelet transfusion to D-negative patients seems an acceptable practice as only 0Á9% patients developed anti-D antibody.

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Section: Discussionsupporting

confidence: 90%

“…As shown in Table , studies employing only SDPC did not have any alloimmunization . Alloimmunization was observed in studies employing both RDPCs and SDPCs or in studies using only RDPCs.…”

Section: Discussioncontrasting

confidence: 55%

Practice of transfusing D‐positive platelets in D‐negative recipients – a reappraisal (POINT‐R)

Dara

Tiwari

Arora

et al. 2015

ISBT Science Series

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“…It can therefore be deduced that PC from apheresis have a lower risk of producing anti-D alloimmunization. This statement is supported by the literature: in none of the studies in which patients were transfused only with PC from a single-donor apheresis, anti-D alloimmunization was detected [6,21,24,25]. These data suggest that anti-D immunoprophylaxis is not necessary in RhD-negative patients receiving exclusively RhD-positive apheresis PC.…”

Section: Discussionsupporting

confidence: 76%

Anti-D Alloimmunization after RhD-Positive Platelet Transfusion in RhD-Negative Women under 55 Years Diagnosed with Acute Leukemia: Results of a Retrospective Study

Villalba

Santiago

Freiria

et al. 2018

Transfus Med Hemother

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Background: Anti-D alloimmunization can occur when platelets from RhD-positive donors are transfused to RhD-negative patients, due to red blood cell residues in the platelet concentrates. Methods: Our objective was to analyze the anti-D alloimmunization rate in a selected group of women under 55 years of age diagnosed with acute leukemia over an 18-year period. We focused the analysis on RhD-negative patients who received RhD-positive platelet transfusions. Results: From January 1998 to October 2016, 382 women under 55 years were diagnosed with acute leukemia. A total of 56 patients were RhD-negative, and 48 (85.7%) received RhD-positive platelets. The median number of platelet concentrates transfused per patient was 23, and 48% of all platelet transfusions were RhD-positive. The 48 RhD-negative patients received a total of 949 RhD-positive platelet concentrates. Two patients developed anti-D: a 36-year-old woman with M3 acute myeloblastic leukemia and a 52-year-old patient with a secondary acute myeloblastic leukemia. Conclusion: We conclude that there is a need for agreement in the transfusion guidelines on the recommendation of anti-D alloimmunization prophylaxis. We suggest a possible benefit in favor of anti-D prophylaxis in childbearing women with acute leukemia.

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“…Earlier studies reported the incidence of D alloimmunization in D-negative recipients of D-positive PC transfusions to be up to 19% [3,14,15,16,17,18]; more recent studies revealed lower frequencies of 0-7% [19,20,21,22,23]. …”

Section: Introductionmentioning

confidence: 99%

Platelet Transfusion Induces Alloimmunization to D and Non-D Rhesus Antigens

Reckhaus

Jutzi

Fontana

et al. 2018

Transfus Med Hemother

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Background: Platelet concentrates (PC) contain residual contaminating red blood cells (RBC), being higher in pooled buffy coat PC (BC-PC) than in apheresis units (AP-PC). Data about PC-induced alloimmunization against non-D Rhesus (Rh) antigens are limited. Methods: For all newly detected RhD and non-D alloantibodies between August 2015 and September /2017 we prospectively evaluated if they were triggered through PC by analyzing for incompatible RBC and/or PC transfusions. Results: We found 5,799 positive results in 89,190 antibody screening tests. We identified 13 newly detectable Rh antibodies through incompatible PCs in 11 patients: 6× anti-D, 4× anti-E, 2× anti-c, 1× anti-f. They received a total of 156 PC (83 BC-PC; 73 AP-PC): 5 patients received incompatible BC-PC only, 1 patient received incompatible AP-PC only, 5 patients received incompatible BC-PC and AP-PC. Quality control showed a mean (range) of 0.304 (0.152-1.662) and 0.014 (0.003-0.080) × 10⁹ RBC/l for BC-PC and AP-PC, respectively. Ten of the 11 patients received RBC transfusions, all of them being antigen-negative for the alloantibodies identified. Conclusions: PC transfusions may not only induce RhD alloimmunization, but also immunization against further Rh antigens such as c, E, and f. The risk seems higher for BC-PC than for AP-PC. The results may have impact on future recommendations of PC transfusion with respect to Rh compatibility and upper limits of RBC contamination.

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Prospective surveillance of D− recipients of D+ apheresis platelets: alloimmunization against D is not detected

Abstract: Prospective surveillance confirms prior retrospective observations that D- patients do not appear to risk D alloimmunization after receiving D+ apheresis PLTs.

Cited by 25 publications

References 23 publications

Practice of transfusing D‐positive platelets in D‐negative recipients – a reappraisal (POINT‐R)

Practice of transfusing D‐positive platelets in D‐negative recipients – a reappraisal (POINT‐R)

Anti-D Alloimmunization after RhD-Positive Platelet Transfusion in RhD-Negative Women under 55 Years Diagnosed with Acute Leukemia: Results of a Retrospective Study

Platelet Transfusion Induces Alloimmunization to D and Non-D Rhesus Antigens

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