The introduction of a platelet crossmatching service at the MDH blood bank.

Abstract

As the demands for long-term use of platelet concentrates in supportive therapy of severely thrombocytopaenic patients increase, platelet alloimmunization and refractoriness have presented a challenging issue in the management of multiply transfused patients. Refractoriness (unresponsiveness to a series of random-donor platelet transfusions), can arise due to patient, clinical and blood bank factors with a major cause being alloimmunization. The Monoclonal Antibody Solid-phase Platelet Antibody Test (Sanquin, Dublin 8, Amsterdam) has been used to crossmatch between 169 different patient plasma specimens and blood group compatible pooled platelet units. The patients included in this study were pregnant females with a history of at least one other pregnancy who had never received a transfusion and multiply transfused patients. The latter group included those being treated for various haematologic and oncologic diseases not excluding patients with sepsis, fever, disseminated intravascular coagulation or those on particular pharmacological treatment. The scope was to evaluate MASP AT kit performance without clinical correlation of results. Of the 168 valid results obtained, 22 donor-recipient pairs would have been indicated by the MASPAT kit to be incompatible. Using a Solid-phase Red Cell Adherence technique (SPRCA), the MASPAT kit has been able to detect alloantibodies present in the patient's plasma to antigens present on the surface of donor platelets. Its performance was evaluated for the prospective introduction of a platelet crossmatching service at the Mater Dei Hospital Blood Bank laboratory.