Absence of anti-D alloimmunization in hematologic patients after D-incompatible platelet transfusions.
BACKGROUND
Rh antigens are not present on the platelet surface. However, platelet concentrates may contain enough RBCs to elicit an anti-D response. Thus, D status must be considered in platelet transfusion. In immunosuppressed patients, frequencies of D alloimmunization of up to 19 percent have been previously reported.


METHODS
Here a prospective study is reported in which 22 D- patients with hematologic disease received D+ platelet transfusions. Platelet concentrates were prepared from whole-blood donations according to the buffy coat method and were pooled before administration. The antibody screen test to detect anti-D was performed by LISS- IAT using the gel test.


RESULTS
Our series comprises 22 immunosuppressed D+ patients with a median age of 56 years (range, 23-79). The patients received 121 D-incompatible pooled platelet transfusions. The mean +/- SD of RBC content was 4.17 +/- 1.74 mL. None of the 22 patients developed detectable anti-D after a median follow-up of 8 weeks (range, 1-37).


CONCLUSIONS
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.
Cid
Joan
J
Center de Transfusió i Banc de Teixits, Hospital Joan XXIII, Tarragona, Spain. jcid@hjxxiii.scs.es
Ortin
Xavier
X
Elies
Enric
E
Castellà
Dolors
D
Panadés
Marta
M
Martín-Vega
Carmen
C
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001787:Blood Group Incompatibility; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D007518:Isoantibodies / Q000097:blood*; D007938:Leukemia / Q000628:therapy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000628:therapy; D017713:Platelet Transfusion / Q000009:adverse effects*; D011446:Prospective Studies; D012204:Rh-Hr Blood-Group System / Q000276:immunology*
D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System