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ABO incompatible platelets for children


dcharland

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At what age do you allow ABO incompatible Apheresis Single Donor Platelets? Presently we use 10 years as the cut off, all children under 10 must receive ABO compatible, if it's not available we wash(!) the Platelet. We don't want to start concentrating and removing the plasma. However, if someone out there has a procedure could you share it?

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I would wonder if a certain body weight might be more meaningful. Children, especially sick ones, can have a huge difference in body size (and therefore blood volume)--or is weight too hard to consistently get in a timely fashion? It is recorded in our computer system once it is established.

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  • 1 year later...

We have validated a washed apheresis platelet procedure on our Cobe 2991 Cell Processor, using 0.9% NaCl in the V2 position. The program is BASICALLY as follows:

Super out Rate = 100 mL/min

Agitate Time = 100 Sec

Super Out Volume = 425 mL

Cycle 1: Spin Time = 10 min, V2

Cycle 2: Spin Time = 5 Min, V2

Cycle 3: Spin Time = 5 min, change Super Out volume to 550 mL

For the Cycle 1 spin timer, if you have a programmable board, you can just set the time to 10 minutes. If you have the old peg-board and dial model, then you have to set the timer to 5 minuts and start with the auto/manual switch set to "Manual". Set a timer for 5 minutes, then press Start/Spin. When your timer goes off, flip the auto/manual switch back to "Auto", and the program will start.

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We make every effort to ABO match or plasma compatible for all of our platelet transfusions. Since we are giving pheresis platelets, giving out of type would be like giving a unit of plasma out of type. Most people would not even consider doing that, but do not hesitate to give out of type platelets.

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'Transfusion efficacy of ABO major-mismatched platelets in children is inferior to that of ABO-identical platelets' TRANSFUSION 2009;49:21-33

In the same issue there is an editorial on the paper called Platelet ABO matters

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