PMID: 15377177Sep 21, 2004Paper

Immunoprophylaxis using intravenous Rh immune globulin should be standard practice when selected D-negative patients are transfused with D-positive random donor platelets

Immunohematology
C A EwingS G Sandler

Abstract

A 67-year-old female developed excessive bleeding and thrombocytopenia following cardiovascular surgery. Her blood type was group A, D-. The only platelet products available in the transfusion service were random donor platelet concentrates from D+ donors. She was transfused with a pool of 6 D+ random donor platelet concentrates. Anti-D undetected in her pretransfusion serum by solid-phase antibody screen was present 11 days later. Retrospectively, the patient provided a history of having two pregnancies more than 40 years ago, prior to the availability of immunoprophylaxis by Rh immune globulin (RhIG). Although studies have shown that as many as 19 percent of D- people may develop anti-D following transfusion of platelets from D+ donors, there is no specific standard requiring immunoprophylaxis with RhIG to prevent Rh alloimmunization after transfusion of random donor platelet concentrates from D+ donors. In contrast, vigorous efforts are routine for preventing Rh alloimmunization in D- patients requiring red cell transfusions or D- females during pregnancy or after delivery of D+ newborns. The absence of a comparable practice standard for platelet transfusions is based, in part, on concern that intramuscular injections of con...Continue Reading

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