PMID- 10875596
OWN - NLM
STAT- MEDLINE
DCOM- 20000717
LR  - 20190921
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 14
IP  - 5
DP  - 1999 Sep-Oct
TI  - Refractoriness to platelet transfusion following double valve replacement in an 
      ITP patient who had undergone splenectomy.
PG  - 386-9
AB  - Reports of patients with idiopathic thrombocytopenic purpura (ITP) undergoing 
      cardiac surgery are rare, and almost all of the reported cases required platelet 
      transfusion. ITP patients, especially those having a history of splenectomy or a 
      history of heavy bleeding, may have to undergo multiple platelet transfusions. 
      Such transfusions may induce alloimmunization against the human leukocyte antigen 
      (HLA) and result in refractoriness to subsequent platelet transfusions. We report 
      a case of a 63-year-old female with ITP, with a history of splenectomy and 
      multiple platelet transfusions, who underwent aortic and mitral valve 
      replacement. Although corticosteroid administration, high-dose immunoglobulin 
      therapy, and repeated platelet transfusion led to a temporary increase in 
      platelet count and successful hemostasis, refractoriness to platelet transfusion 
      occurred postoperatively because of the presence of the anti-HLA antibody. In 
      addition, the patient showed complications of pyothorax. Corticosteroids might 
      have exerted an inhibitory influence on the occurrence of pyothorax.
FAU - Kaneda, T
AU  - Kaneda T
AD  - Department of Cardiovascular Surgery, Kinki University School of Medicine, Osaka, 
      Japan. toshio_kaneda@hotmail.com
FAU - Ku, K
AU  - Ku K
FAU - Oku, H
AU  - Oku H
FAU - Inoue, T
AU  - Inoue T
FAU - Matsumoto, T
AU  - Matsumoto T
FAU - Onoe, M
AU  - Onoe M
FAU - Kitayama, H
AU  - Kitayama H
FAU - Lemura, J
AU  - Lemura J
FAU - Nakamoto, S
AU  - Nakamoto S
FAU - Oka, H
AU  - Oka H
FAU - Otaki, M
AU  - Otaki M
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Aortic Valve/surgery
MH  - Female
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Middle Aged
MH  - Mitral Valve/surgery
MH  - Platelet Count
MH  - *Platelet Transfusion
MH  - Postoperative Complications/blood/*therapy
MH  - Postoperative Hemorrhage/blood/therapy
MH  - Purpura, Thrombocytopenic, Idiopathic/blood/*therapy
MH  - Retreatment
MH  - *Splenectomy
EDAT- 2000/06/30 11:00
MHDA- 2000/07/25 11:00
CRDT- 2000/06/30 11:00
PHST- 2000/06/30 11:00 [pubmed]
PHST- 2000/07/25 11:00 [medline]
PHST- 2000/06/30 11:00 [entrez]
AID - 10.1111/j.1540-8191.1999.tb01015.x [doi]
PST - ppublish
SO  - J Card Surg. 1999 Sep-Oct;14(5):386-9. doi: 10.1111/j.1540-8191.1999.tb01015.x.