PMID: 9174547Apr 1, 1997Paper

Frequency and causes of refractoriness in multiply transfused patients

Annals of Hematology
T J LeglerM Köhler

Abstract

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 p...Continue Reading

Citations

Dec 20, 1999·Transfusion Medicine Reviews·L A Chambers, J H Herman
Jun 16, 2001·Transfusion·V KiefelS Santoso
Apr 9, 2005·Journal of Thrombosis and Thrombolysis·Hakan OzdoguEbru Kizilkilic
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