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Blood transfusion = Trasfusione del sangue
Apr, 2014;12 (2): 187-94.

Evaluation of platelet cross-matching in the management of patients refractory to platelet transfusions.

Osama S Salama, Doaa A Aladl, Doaa M El Ghannam, Wesam E Elderiny
Author Information
  1. Osama S Salama: Departments of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
  2. Doaa A Aladl: Departments of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
  3. Doaa M El Ghannam: Departments of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
  4. Wesam E Elderiny: Departments of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
PMID: 24931840 DOI: 10.2450/2014.0120-13

Abstract

BACKGROUND: Cross-match-compatible platelets are used to support thrombocytopenic patients who are refractory to randomly selected platelets. However, few studies have addressed the efficacy of using this strategy for patients requiring intensive platelet transfusion therapy. The aim of this study was to determine the effectiveness of cross-match-compatible platelets in an unselected group of patients refractory to platelets from random donors.
MATERIALS AND METHODS: A total of 406 cross-match-compatible platelet components were administered to 40 evaluable patients who were refractory to random-donor platelets. A solid-phase red cell adherence method was used for platelet cross-matching. The corrected count increment was used to monitor the effectiveness of each platelet transfusion. Multivariate analysis was performed to detect whether any variables could predict the response to transfusion.
RESULTS: Statistically significant improvements were found in the mean corrected count increment when comparing cross-match-compatible platelets with randomly selected and incompatible platelets (p<0.001 for each). Compatible platelet transfusions were associated with a good response in 72.9% of cases while incompatible platelets were associated with a poor response in 66.7% of transfusion events (p<0.001). In the presence of clinical factors or alloimmunisation, compatible platelets were associated with good responses in 67.9% and 28.0% respectively vs 100% and 93.3% in their absence (p=0.009, p<0.001). Multivariate analysis revealed that cross-matching and alloimmunisation were the strongest predictors of transfusion response at 1 hour, while ABO compatibility, type of units received, followed by alloimmunisation then clinical factors were predictors at 24 hours.
DISCUSSION: Platelet cross-matching using the solid-phase red cell adherence technique is an effective and rapid first-line approach for the management of patients refractory to platelet transfusions.

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MeSH Term

Adult
Blood Group Incompatibility
Blood Grouping and Crossmatching
Blood Platelets
Female
Humans
Male
Middle Aged
Platelet Transfusion
Sensitivity and Specificity
Journal Article Randomized Controlled Trial

Word Cloud

Created with Highcharts 10.0.0plateletsplateletpatientsrefractorytransfusioncross-matchingresponseusedcross-match-compatiblep<0001transfusionsassociatedalloimmunisationrandomlyselectedusingeffectivenesssolid-phaseredcelladherencecorrectedcountincrementMultivariateanalysisincompatiblegood9%clinicalfactorspredictorsmanagementBACKGROUND:Cross-match-compatiblesupportthrombocytopenicHoweverstudiesaddressedefficacystrategyrequiringintensivetherapyaimstudydetermineunselectedgrouprandomdonorsMATERIALSANDMETHODS:total406componentsadministered40evaluablerandom-donormethodmonitorperformeddetectwhethervariablespredictRESULTS:StatisticallysignificantimprovementsfoundmeancomparingCompatible72casespoor667%eventspresencecompatibleresponses67280%respectivelyvs100%933%absencep=0009revealedstrongest1hourABOcompatibilitytypeunitsreceivedfollowed24hoursDISCUSSION:Platelettechniqueeffectiverapidfirst-lineapproachEvaluation

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