PMID- 29664113
OWN - NLM
STAT- MEDLINE
DCOM- 20190102
LR  - 20200108
IS  - 1537-2995 (Electronic)
IS  - 0041-1132 (Linking)
VI  - 58
IP  - 7
DP  - 2018 Jul
TI  - Peripartum management of HLA alloimmune platelet refractoriness.
PG  - 1583-1587
LID - 10.1111/trf.14636 [doi]
AB  - BACKGROUND: Platelet (PLT) refractoriness presents a challenging problem for 
      transfusion support, especially in the perioperative setting, where there is 
      urgency for human leukocyte antigen (HLA)-compatible units, yet identification 
      and provision of compatible PLT concentrates requires time. CASE REPORT: A 
      22-year-old G3P1 woman with thrombocytopenia due to aplastic anemia, likely 
      autoimmune, presented in her third trimester for peripartum care and newly 
      diagnosed HLA alloimmune PLT refractoriness. Despite early planning, the patient 
      developed bleeding requiring urgent delivery. Notably, the patient also developed 
      strong allele-specific HLA antibody, precluding the use of HLA-matched PLTs. 
      RESULTS: Using full-range HLA testing services and multidisciplinary physician 
      planning, several HLA-compatible PLT concentrates were procured to support her 
      peripartum bleeding. CONCLUSION: We describe what appears to be the first 
      reported case of management of transfusion support of PLT refractoriness 
      peripartum. Although complicated by allele-specific HLA antibodies, using a 
      combination of acceptable low-level antibodies and crossmatching we successfully 
      identified HLA-compatible PLT concentrates resulting in posttransfusion PLT count 
      increments.
CI  - (c) 2018 AABB.
FAU - Pena, Jeremy Ryan
AU  - Pena JR
AD  - Department of Pathology, Beth Israel Deaconess Medical Center, and Harvard 
      Medical School, Boston, Massachusetts.
FAU - Sudhof, Leanna
AU  - Sudhof L
AD  - Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 
      and Harvard Medical School, Boston, Massachusetts.
FAU - O'Brien, Barbara
AU  - O'Brien B
AD  - Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 
      and Harvard Medical School, Boston, Massachusetts.
LA  - eng
PT  - Case Reports
DEP - 20180417
PL  - United States
TA  - Transfusion
JT  - Transfusion
JID - 0417360
RN  - 0 (Antigens, Human Platelet)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Antigens, Human Platelet/immunology
MH  - Female
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Peripartum Period
MH  - Platelet Transfusion
MH  - Pregnancy
MH  - Thrombocytopenia/*immunology/*therapy
MH  - Young Adult
EDAT- 2018/04/18 06:00
MHDA- 2019/01/03 06:00
CRDT- 2018/04/18 06:00
PHST- 2017/10/16 00:00 [received]
PHST- 2018/02/14 00:00 [revised]
PHST- 2018/02/23 00:00 [accepted]
PHST- 2018/04/18 06:00 [pubmed]
PHST- 2019/01/03 06:00 [medline]
PHST- 2018/04/18 06:00 [entrez]
AID - 10.1111/trf.14636 [doi]
PST - ppublish
SO  - Transfusion. 2018 Jul;58(7):1583-1587. doi: 10.1111/trf.14636. Epub 2018 Apr 17.