Refractory response to platelet transfusion therapy.
Platelet transfusions are commonly used for prophylaxis and treatment of bleeding. After a transfusion, an increment or "boost" is expected to occur. While a number of factors can contribute to a poor posttransfusion increment, refractoriness is typically defined as failure to achieve an appropriate increment after receiving 2 consecutive transfusions with fresh ABO-compatible platelets. The most common cause of refractoriness is contamination of the platelet product with leukocytes, resulting in human leukocyte antigens antibody formation. ABO incompatibility and human platelet antigens are also implicated in the development of refractoriness. Nurses who infuse platelets must understand these causes to assist in prevention and management.
Eisenberg
Seth
S
Infusion Services, Seattle Cancer Care Alliance, Seattle, Washington 98109, USA. seisenbe@seattlecca.org
D000017:ABO Blood-Group System; D016824:Antigens, Human Platelet / Q000032:analysis / Q000276:immunology; D001787:Blood Group Incompatibility; D001788:Blood Grouping and Crossmatching; D006680:HLA Antigens / Q000032:analysis / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D017713:Platelet Transfusion / Q000451:nursing; D013921:Thrombocytopenia / Q000628:therapy*; D017211:Treatment Failure
D000017:ABO Blood-Group System; D016824:Antigens, Human Platelet; D006680:HLA Antigens