Transfusions after Post-Transfusion Purpura

[bbbirder]

If a patient had Post-Transfusion Purpura, do you give washed products for future transfusions?

There seem to be conflicting opinions about this.

Linda Frederick

[scodina]

We do not give washed platelets after a PTP reaction. We do give crossmatched or HLA-matched platelets. We only have one current patient who has had a PTP reaction, and she has not had a problem tolerating the crossmatched platelets.

Her initial reaction was quite severe. She was a multiple-trauma patient who required several life-saving surgeries during her first few days in the hospital. Her platelet count first dropped on Christmas eve, so there was a slight delay before we could get her crossmatched/HLA-matched platelets.

[bbbirder]

What about Red Cells?

We have a patient who had PTP, her platelet count dropped to 4 after RBC (Leukocyte reduced) transfusion. She responded well to IVIG.

My understanding of PTP is that it occurs when the antibody titer has dropped significantly and occurs in conjunction with the rise of antibody. Once the antibody levels are up, no more PTP....?

But how handle this? There is no way to know if the antibody levels are high or low, so do you just do the prudent thing and give washed RBCs?

What about women who have a history of an infant with NITP? They are at risk of developing PTP in the future.

Thanks,

Linda Frederick