Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: email@example.com. Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis. 2019;:102657
BACKGROUND Platelet refractoriness, which leads to platelet transfusion failure resulting in significant morbidity and long hospital stay, is routinely not investigated. AIMS To determine the efficacy of cross-match compatible platelets in multi-transfused alloimmunized hemato-oncological patients refractory to platelet transfusion. MATERIALS AND METHOD 149 ABO compatible single donor apheresis platelet transfusions given to 38 alloimmunized refractory patients. Corrected Count Increment (CCI)
<5000 (1h) was taken to define refractoriness. Solid-phase red cell adherence assay was used to determine the alloimmunization status and platelet cross-matching. Post Transfusion Platelet Increment, CCI and the Percentage Platelet Recovery were used to monitor the effectiveness of platelet transfusion. ANOVA test followed by Post hoc test Tukey HSD used to compare group means and classified into three groups depending upon the cross-matching and compatibility status. Categorical data was analysed for various outcomes using Pearson's chi square test or Fischer exact test. RESULT Patients showed statistically significant recovery in terms of PPI, CCI and PPR at 1h post SDAP transfusions when they received cross-matched compatible platelets. The one-hour CCI was significantly higher for cross-match-compatible platelets (19173+/-2692) than for incompatible (5888+/-1526) and for uncross-matched (8140+/-1480). Forty four (97.8%) of 45 cross-matched compatible platelet transfusion episodes showed a satisfactory response in terms of PPI and CCI values as compared to 50 % and 53.9% in uncross-matched group respectively (p<0.0001). CONCLUSION Platelet cross-matching is an effective intervention in the management of multi-transfused alloimmunized Haemato-oncological patients, refractory to platelet transfusion.