title: Easier said than done: ABO compatibility and D matching in apheresis platelet transfusions.
abstract: BACKGROUND
  Many hospital transfusion services prioritize ABO plasma compatibility in platelet (PLT) transfusion to minimize risk for acute hemolytic transfusion reactions. In spite of the low risk of D alloimmunization associated with apheresis PLT transfusion, attempts may also be made to provide D- PLTs to D- patients. This study was undertaken to assess how often ABO compatibility and/or D matching occurs at our institution and how the ABO and D mix of our PLT supply impacts PLT selection.
  
  
  METHODS
  We retrospectively reviewed the ABO and D type of all PLTs transfused plus the age, sex, and ABO and D type of all PLT recipients between January 2010 and March 2014 (51 months).
  
  
  RESULTS
  We provided ABO-identical PLTs for 5281 (54.6%), ABO plasma-compatible and cellular-incompatible for 3136 (32.4%), ABO low-titer plasma-incompatible and cellular-compatible for 1150 (11.9%), ABO plasma-incompatible and cellular-compatible for 30 (0.3%), and ABO plasma-incompatible and cellular-incompatible for 72 (0.7%). PLT supply did not match PLT demand based on patient ABO type, primarily due to a lower than expected supply of group O PLTs and higher than expected supply of group A and AB. D- patients were less likely to receive ABO-identical PLT transfusions (p = 0.0008), but were more likely to receive D- PLT transfusions (p < 0.0001).
  
  
  CONCLUSIONS
  At our hospital, available inventory and PLT selection practices resulted in the majority of group O patients receiving cellular-incompatible PLT transfusions. Efforts to provide D- PLTs to D- patients also resulted in fewer D- patients receiving ABO-identical PLT transfusions.
authors.affiliation: Department of Pathology.|Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Dunbar
authors.affiliation: Department of Pathology.|Community Blood Services, Montvale, New Jersey.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Katus
authors.affiliation: Department of Pathology.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Freeman
authors.affiliation: Department of Pathology.|Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
authors.forename: Zbigniew M
authors.initials: ZM
authors.lastname: Szczepiorkowski
mesh_terms: D000017:ABO Blood-Group System / Q000032:analysis* / Q000276:immunology; D000046:Academic Medical Centers / Q000706:statistics & numerical data; D001787:Blood Group Incompatibility / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D017713:Platelet Transfusion / Q000009:adverse effects* / Q000706:statistics & numerical data; D010983:Plateletpheresis; D012189:Retrospective Studies; D012204:Rh-Hr Blood-Group System / Q000032:analysis* / Q000276:immunology; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D065227:Transfusion Reaction / Q000453:epidemiology
chemical_list: D000017:ABO Blood-Group System; D012204:Rh-Hr Blood-Group System