Low frequency of anti‐D alloimmunization following D+ platelet transfusion: the Anti‐D Alloimmunization after D‐incompatible Platelet Transfusions (ADAPT) study |
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| Authors: | Joan Cid Miguel Lozano Alyssa Ziman Kamille A. West Kerry L. O'Brien Michael F. Murphy Silvano Wendel Alejandro Vázquez Xavier Ortín Tor A. Hervig Meghan Delaney Willy A. Flegel Mark H. Yazer the Biomedical Excellence for Safer Transfusion collaborative |
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| Affiliation: | 1. Department of Haemotherapy and Haemostasis, Hospital Clínic, IDIBAPS, UB, Barcelona, Spain;2. Clinical Center, Department of Transfusion Medicine, National Institutes of Health, Bethesda, MD, USA;3. UCLA Division of Transfusion Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA;4. Department of Pathology, Beth Israel Deaconess Medical Centre, Boston, MA, USA;5. Oxford University Hospitals and NHS Blood & Transplant, Oxford, UK;6. Hospital Sirio Libanes Blood Bank, S?o Paulo, Brazil;7. Department of Blood Transfusion, Hospital Universitario Puerta de Hierro, Majadahonda, Spain;8. Department of Haematology, Hospital Verge de la Cinta, Tortosa, Spain;9. Department of Clinical Science, Haukeland University Hospital, University of Bergen, Bergen, Norway;10. Puget Sound Blood Center, Department of Laboratory Medicine, University of Washington, Seattle, WA, USA;11. Department of Pathology, Institute for Transfusion Medicine, University of Pittsburgh, Pittsburgh, PA, USA |
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| Abstract: | The reported frequency of D alloimmunization in D? recipients after transfusion of D+ platelets varies. This study was designed to determine the frequency of D alloimmunization, previously reported to be an average of 5 ± 2%. A primary anti‐D immune response was defined as the detection of anti‐D ≥ 28 d following the first D+ platelet transfusion. Data were collected on 485 D? recipients of D+ platelets in 11 centres between 2010 and 2012. Their median age was 60 (range 2–100) years. Diagnoses included: haematological (203/485, 42%), oncological (64/485, 13%) and other diseases (218/485, 45%). Only 7/485 (1·44%; 95% CI 0·58–2·97%) recipients had a primary anti‐D response after a median serological follow‐up of 77 d (range: 28–2111). There were no statistically significant differences between the primary anti‐D formers and the other patients, in terms of gender, age, receipt of immunosuppressive therapy, proportion of patients with haematological/oncological diseases, transfusion of whole blood‐derived or apheresis platelets or both, and total number of transfused platelet products. This is the largest study with the longest follow‐up of D alloimmunization following D+ platelet transfusion. The low frequency of D alloimmunization should be considered when deciding whether to administer Rh Immune Globulin to D? males and D? females without childbearing potential after transfusion of D+ platelets. |
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| Keywords: | platelet transfusion D compatibility anti‐D alloantibodies alloimmunization RhIG |
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