Principle:
Platelets have only weak ABO antigen expression but contain the naturally occurring antibodies of the original donor.
Policy:
- 20 kg or more:
- Platelets of any ABO/D type may be given to any patient
- Below 20 kg:
- First choice: ABO identical
- Second choice: Plasma compatible
- Third choice: Platelet components in platelet additive solution PAS
- Fourth choice: Contact transfusion medicine for use of plasma-incompatible type
- Do NOT volume reduce platelets: this adversely affects platelet function and requires a prolonged recuperation period of several hours before the platelets can be transfused. Platelets in additive solution have only minimal residual plasma (35 ml out of 200 ml volume).
- There is no need to chose platelet types from a D-compatible donor because we use methods that minimize RBC contamination (automated component processing to prepare buffy coats for pooling or apheresis).
- It is at the discretion of the ordering physician if he wants to consider Rh immunoprophylaxis if D-incompatible type is chosen.
References:
- Standards for Blood Banks and Transfusion Services, Current Edition, AABB, Bethesda, MD, USA
- Guidelines to the Preparation, Use, and Quality Assurance of Blood Components, European Committee (Partial Agreement) on Blood Transfusion (CD-P-TS), Current Edition