Outcomes of an automated procedure for the selection of effective platelets for patients refractory to random donors based on cross-matching locally available platelet products.
In 1999, we implemented an automated platelet cross-matching (XM) programme to select compatible platelets from the local inventory for patients refractory to random donor platelets. In this study, we evaluated platelet count increments in 40 consecutive refractory patients (8.3% of 480 consecutive platelet recipients) given 569 cross-match-negative platelets between April 1999 and December 2001. XM was performed automatically with a commercially available immunoadherence assay. Pre-, 1- and 24-h post-transfusion platelet counts (mean +/- SD) for the 569 XM-negative platelet transfusions containing 302 +/- 71 x 109 platelets were 7.7 +/- 5.5, 32.0 +/- 21.0 and 16.8 +/- 15.5 x 109/l respectively. Increments were significantly higher (P < 0.05, t-test) than those observed in the same patients given 303 random platelet pools (dose = 318 +/- 52 x 109 platelets) during the month before refractoriness was detected, when pre-, 1- and 24-h post-transfusion counts were 7.0 +/- 8.6, 15.9 +/- 16.1 and 9.6 +/- 12.8 x 109/l respectively. The cost of the platelet XM disposable kit per transfusion to produce 1-h post-transfusion platelet count increments >10 x 109/l was euro 447. This programme enabled the rapid selection of effective platelets for refractory patients, from the local inventory.
Rebulla
Paolo
P
Centro Trasfusionale e di Immunologia dei Trapianti Department of Haematology, IRCCS Ospedale Maggiore, Milano Istituto Europeo di Oncologia, Milano, Italy. prebulla@libero.it
Morelati
Fernanda
F
Revelli
Nicoletta
N
Villa
Maria Antonietta
MA
Paccapelo
Cinzia
C
Nocco
Angela
A
Greppi
Noemi
N
Marconi
Maurizio
M
Cortelezzi
Agostino
A
Fracchiolla
Nicola
N
Martinelli
Giovanni
G
Deliliers
Giorgio Lambertenghi
GL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001788:Blood Grouping and Crossmatching / Q000379:methods*; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000096:biosynthesis; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D017713:Platelet Transfusion; D015397:Program Evaluation; D016896:Treatment Outcome
D006680:HLA Antigens; D007518:Isoantibodies