Maternal HLA antibodies

[3cardmoe]

Currently, we have a set of preemie twins who require multiple platelet transfusions. Testing was performed on a maternal sample and it was discovered that mom has HLA antibodies. The neonatologist (in conjunction with our Medical Director) has recommended that the neonates receive crossmatch compatible platelets (compatibility testing being performed with moms sample). Since our blood supplier's policy states that crossmatches are 'good' for 7 days we are requiring the mom to come back in and get additional samples drawn to send off to the blood supplier each week.

Of course this brings up a lot of questions in the department.  Its been difficult getting the mom drawn since she's no longer an 'active' patient with her OB and she's technically not a patient of the neonatologist. Also, how can we properly bill since we're using moms sample to perform testing to provide product for babies?

Just in general, how would your facility handle a situation like this?

[Malcolm Needs ☆]

We would sort out the specificity of the maternal HLA antibodies, and then give antigen negative platelets, with no cross-matching, as the babies are not going to be producing any HLA antibodies, and, if the mother does, it is not going to affect this set of twins.