Platelet Transfusion Refractoriness

Research output: Book chapter/Published conference paperConference paper

Abstract

Platelet Transfusion RefractorinessBy: Dr Seyed Reza Mortazavi, School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSWPlatelet transfusion has been used for decades as a highly beneficial therapeutic measure to prevent or stop bleeding in patients with severe thrombocytopenia by increasing the circulatory platelet numbers. This procedure is an essential and effective component of the therapeutic protocols for patients who show a dangerous degree of thrombocytopenia due to acute leukaemia, bone marrow failure, transplantation-related treatments, massive transfusion or other causes. Nevertheless, in some patients common platelet transfusion practices fail to achieve the expected objectives. The platelet transfusion refractoriness may have non-immunological and immunological causes. According to an article published in the Lancet in 2007, the non-immunological causes comprise 72%- 88% of all cases while the immunological types account for only 25-39% of the incidents (Stroncek & Rebulla). There is an array of non-immune causes including splenomegaly, sepsis, disseminated intravascular coagulation, and some drugs such as the antibiotic vancomycin. On the other hand, HLA alloantibodies have been blamed as the most common causative agents for the immunological platelet refractoriness followed by antibodies against platelet-specific antigens, and anti-A or anti-B in ABO-incompatible recipients. (Saw et al., 2010); (McFarland, 2011).The management of platelet transfusion refractoriness could be as challenging as its diagnosis as it may require a comprehensive consideration of many factors. For immunologic cases, transfusion with apheresis platelets obtained from class I HLA-similar donors or even cross-matched platelet units may be the best choices (McFarland, 2011) while non-immunological types such as those secondary to splenomegaly or sepsis need their own specific treatments. ReferencesMcFarland, J. G. (2011). Platelet and granulocyte antigens and antibodies. In J. D. Roback, B. J. Grossman, T. Harris & C. D. Hillyer (Eds.), Technical manual (17 ed., pp. 523-545). Maryland: American Association of Blood Banks.Saw, C.-L., Szykoluk, H., Curtis, B. R., Zelcer, S., Eckert, K., Forrest, D., . . . Goldman, M. (2010). Two cases of platelet transfusion refractoriness associated with anti-CD36. Transfusion, 50(12), 2638-2642. doi: 10.1111/j.1537-2995.2010.02749.xStroncek, D. F., & Rebulla, P. Platelet transfusions. The Lancet, 370(9585), 427-438. doi: http://dx.doi.org/10.1016/S0140-6736(07)61198-2
Original languageEnglish
Title of host publicationNICE 2013
EditorsKirk Sowinski
PublisherNICE
Pages47
Number of pages1
Publication statusPublished - 2013
EventScientific Meeting of National Immunohaematology Continuing Education (NICE) - Albury, NSW, Australia
Duration: 22 Nov 201324 Nov 2013

Conference

ConferenceScientific Meeting of National Immunohaematology Continuing Education (NICE)
CountryAustralia
Period22/11/1324/11/13

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    Mortazavi, S. (2013). Platelet Transfusion Refractoriness. In K. Sowinski (Ed.), NICE 2013 (pp. 47). NICE.