Isohemagglutinin titration in pooled and apheresis platelets.

Autor:	Hua Q; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada., Lyon BW; Transfusion & Transplantation Medicine Program, Alberta Precision Laboratories, Edmonton, Alberta, Canada., Duke J; Transfusion & Transplantation Medicine Program, Alberta Precision Laboratories, Edmonton, Alberta, Canada., Felske A; Transfusion & Transplantation Medicine Program, Alberta Precision Laboratories, Edmonton, Alberta, Canada., Hobbs K; Transfusion & Transplantation Medicine Program, Alberta Precision Laboratories, Edmonton, Alberta, Canada., Holman R; Transfusion & Transplantation Medicine Program, Alberta Precision Laboratories, Edmonton, Alberta, Canada., Radwi G; Transfusion & Transplantation Medicine Program, Alberta Precision Laboratories, Edmonton, Alberta, Canada., Sidhu D; Transfusion & Transplantation Medicine Program, Alberta Precision Laboratories, Edmonton, Alberta, Canada., Clarke G; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada., Nahirniak S; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.; Transfusion & Transplantation Medicine Program, Alberta Precision Laboratories, Edmonton, Alberta, Canada.
Jazyk:	angličtina
Zdroj:	Transfusion [Transfusion] 2024 Jul; Vol. 64 (7), pp. 1279-1286. Date of Electronic Publication: 2024 May 25.
DOI:	10.1111/trf.17873
Abstrakt:	Background: Platelet inventory constraints necessitate ABO-incompatible platelet transfusion. Many minimize the hemolytic impact by confirming low titre (LT) donor isohemagglutinins. This process is costly. Pathogen-reduced platelets (PRP) in platelet additive solutions (PAS) will dilute plasma and decrease high-titre isohemagglutinins (HT). We determined the proportion of HT platelets and incompatible transfusions for units suspended in plasma to reassess the need for titres following introduction of PRP/PAS. Study Design and Methods: Our titre method is manual tube (1:50) dilution of platelet supernatant from apheresis or whole blood derived buffy coat pools suspended in plasma, tested with A1/B red cells. Testing included 49,058 pooled and 11,738 apheresis platelets over 4 years. The HT proportion, rate of out-of-group transfusions, and hemolytic reactions were determined. The impact of PAS dilution was estimated. Results: Totally 60,796 platelet units were tested. Group O pooled and group B apheresis platelets had HT in 6.6% and 5.7%, respectively. Group A pooled and apheresis platelets included 2% with HT. Approximately 25% of platelets transfused were ABO-incompatible and no hemolytic reactions were reported. Based on the proportions of PAS-E and plasma for PRP platelets, plasma from each donor comprises 11 mL (6% of total volume) vs 20-257 mL in untreated pools. PAS-E will replace and dilute residual plasma by at least 50%. Discussion: Rare platelet pools may demonstrate HT. PRP platelets with PAS will reduce titres and may abrogate the need for titration. A strategy of group specific transfusion or transfusion of group A PRP platelet transfusions may be a safe alternative. (© 2024 The Authors. Transfusion published by Wiley Periodicals LLC on behalf of AABB.)
Databáze:	MEDLINE
Externí odkaz:	Plný text