Document Detail

Frequency and causes of refractoriness in multiply transfused patients.
MedLine Citation:
PMID:  9174547     Owner:  NLM     Status:  MEDLINE    
The use of leukocyte-depleted blood components has become the standard therapy for multiply transfused patients during the past few years, as a measure to reduce the frequency of alloimmunization and refractoriness. We assessed frequency and causes of refractoriness, defined as a repeated 24-h post-transfusion platelet count below 20,000/microliters, in 145 consecutive patients who received three or more single-donor platelet concentrates during a 1-year period. Flow-cytometric detection of anti-platelet antibodies and a glycoprotein-specific ELISA were applied for the diagnosis of alloimmunization. Forty patients (27.6%) had at least one episode of refractoriness. In 25 of these 40 patients (62.5%), nonimmune factors (fever, sepsis, coagulopathy, splenomegaly) alone were the cause. In 15 refractory patients alloantibodies were detected. In seven patients (17.5%), alloimmunization alone caused an inadequate transfusion response, while in eight refractory patients (20.0%) alloimmunization and fever or sepsis were present. HLA antibodies were detected in 17 patients (11.7%); three patients (2%) had platelet-specific antibodies in addition to HLA antibodies; in two patients panreactive platelet antibodies were detectable. All 17 patients had a history of previous transfusions or pregnancy. We did not observe primary immunization in patients transfused exclusively with filtered (leukodepleted) blood products. Our data suggest that alloimmunization in patients with a negative risk history can be prevented by the exclusive use of leukodepleted blood components.
T J Legler; I Fischer; J Dittmann; G Simson; R Lynen; A Humpe; J Riggert; E Schleyer; W Kern; W Hiddemann; M Köhler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of hematology     Volume:  74     ISSN:  0939-5555     ISO Abbreviation:  Ann. Hematol.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-06-18     Completed Date:  1997-06-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9107334     Medline TA:  Ann Hematol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  185-9     Citation Subset:  IM    
Department of Transfusion Medicine, University of Göttingen, Germany.
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MeSH Terms
Antigens, Human Platelet / immunology
Flow Cytometry
HLA Antigens / immunology
Immunoglobulin G / immunology
Isoantibodies / analysis*
Platelet Transfusion*
Reg. No./Substance:
0/Antigens, Human Platelet; 0/HLA Antigens; 0/Immunoglobulin G; 0/Isoantibodies

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