AI Article Synopsis
- Anti-D antibodies can develop in D- patients after they receive D+ platelet transfusions, which is a concern for women of childbearing age due to potential risks for their newborns.
- A systematic review of 22 studies found that 3.3% of D- patients formed anti-D antibodies after receiving D+ platelets, with women and those receiving whole blood-derived platelets having higher rates.
- The study suggests implementing anti-D prophylaxis for women who receive D+ platelets to minimize the risk of hemolytic disease in future pregnancies.
Article Abstract
Background: Anti-D can be formed after D-incompatible platelet transfusions due to contaminating D+ red blood cells. These antibodies are of particular importance in women of childbearing potential, because anti-D is most often involved in severe cases of hemolytic disease of the fetus and newborn. This systematic review determined the frequency of anti-D after D+ platelet transfusions and risk factors for D alloimmunization.
Study Design And Methods: Relevant literature was searched using PubMed, Embase and Web of Science until December 2022. Overall anti-D frequency and risk factors were estimated using a random effects meta-analysis.
Results: In 22 studies, a total of 3028 D- patients received a mean of six D+ platelet transfusions. After a mean follow-up of seven months 106 of 2808 eligible patients formed anti-D. The pooled anti-D frequency was 3.3% (95% CI 2.0-5.0%; I 71%). After including only patients with an undoubtable follow-up of at least 4 weeks, 29 of 1497 patients formed anti-D with a pooled primary anti-D rate of 1.9% (95% CI 0.9-3.2%, I 44%). Women and patients receiving whole blood derived platelets had two and five times higher anti-D rates compared with men and patients receiving apheresis derived platelets, respectively.
Discussion: Anti-D immunization is low after D incompatible platelet transfusions and dependent on recipients' sex and platelet source. We propose anti-D prophylaxis in girls and women, capable of becoming pregnant in the future, that received D+ platelets, regardless of platelet source, to reduce the risk of anti-D induced hemolytic disease of the fetus and newborn.
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| http://dx.doi.org/10.1111/trf.17833 | DOI Listing |
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