Does ABO and RhD matching matter for platelet transfusion?

Hematology Am Soc Hematol Educ Program. 2020 Dec 4;2020(1):512-517. doi: 10.1182/hematology.2020000135.

Abstract

Platelets express ABO antigens and are collected in plasma, which contains ABO antibodies as would be consistent with the donor ABO group. Platelet ABO antigens that are incompatible with recipient ABO antibodies may have accelerated clearance from circulation and result in lower count increments. ABO antibodies that are passively transferred from donor plasma may result in hemolysis of recipient red blood cells. Although platelets do not express Rh antigens, they contain small numbers of intact red blood cells or fragments, which can lead to alloimmunization in the recipient. Alloimmunization to the RhD antigen may occur when platelets obtained from RhD-positive donors are transfused to RhD-negative recipients. All of these compatibility considerations must be balanced against the available supply, which may be limited due to the 5- to 7-day shelf life of platelets. This articles describes considerations for platelet ABO and RhD selection for platelet transfusions, including the impact of major ABO incompatibility on count increments, the risks of hemolysis associated with minor ABO incompatibility, and the risk of RhD alloimmunization when RhD-negative patients receive platelets obtained from RhD-positive donors.

Publication types

  • Case Reports
  • Review

MeSH terms

  • ABO Blood-Group System* / blood
  • ABO Blood-Group System* / immunology
  • Blood Group Incompatibility / blood
  • Blood Group Incompatibility / immunology
  • Blood Grouping and Crossmatching*
  • Erythrocytes / immunology
  • Erythrocytes / metabolism
  • Female
  • Humans
  • Middle Aged
  • Platelet Transfusion*
  • Rh-Hr Blood-Group System* / blood
  • Rh-Hr Blood-Group System* / immunology
  • Transfusion Reaction* / blood
  • Transfusion Reaction* / immunology
  • Transfusion Reaction* / prevention & control

Substances

  • ABO Blood-Group System
  • Rh-Hr Blood-Group System
  • Rho(D) antigen