Lauren K Dunn, Emily Venner, Matthew Nguyen, Jose Perdomo Trejo, Zachary Holley, Bhiken I Naik, Jenna Khan, Michael Mazzeffi
{"title":"ABO-identical versus incompatible platelet transfusion in patients with intracranial hemorrhage.","authors":"Lauren K Dunn, Emily Venner, Matthew Nguyen, Jose Perdomo Trejo, Zachary Holley, Bhiken I Naik, Jenna Khan, Michael Mazzeffi","doi":"10.1371/journal.pone.0312602","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Patients with spontaneous and traumatic intracranial hemorrhage (ICH) are frequently transfused platelets to treat thrombocytopenia, platelet function defects, and reverse antiplatelet drugs. ABO-identical platelet transfusion has been suggested to lead to higher post-transfusion platelet increments compared to major-ABO incompatible transfusion. We hypothesized that patients who received ABO-identical transfusion would have higher post-transfusion platelet increments and superior neurologic outcomes.</p><p><strong>Methods: </strong>Adults with traumatic or non-traumatic ICH from January 1st 2018 to December 31st 2022 were identified using electronic medical records and international classification of disease (ICD)-10 codes. Patients were excluded if they lacked a platelet count within 24 hours before and within 24 hours after transfusion or if they received multiple platelet transfusions before their platelet count was remeasured. After stratification by ABO-identical, ABO-major incompatible, and ABO-minor incompatible transfusion, post transfusion increments were compared, as were clinical outcomes.</p><p><strong>Results: </strong>Among 167 patients who received platelet transfusion, 76 (45.5%) received ABO-identical transfusion, 54 (32.3%) received ABO-major incompatible transfusion, and 37 (22.2%) received ABO-minor incompatible transfusion. There were no significant differences in absolute platelet increment between groups. The median increment was 7x109/L for ABO-identical platelets, 10x109/L for ABO-major incompatible platelets, and 11x109/L for ABO-minor incompatible platelets, p = .87. There was no significant difference in the percentage of patients discharged alive with modified Rankin score of 1 or 2 or cerebral performance category 1 or 2 between groups (p = .56 and .39 respectively). After adjusting for confounders in a general linear model there remained no associations between ABO compatibility and platelet increment after transfusion.</p><p><strong>Conclusions: </strong>Our data support similar efficacy for ABO-identical and ABO-incompatible platelet transfusion in patients with ICH.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"19 11","pages":"e0312602"},"PeriodicalIF":2.9000,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581237/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PLoS ONE","FirstCategoryId":"103","ListUrlMain":"https://doi.org/10.1371/journal.pone.0312602","RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MULTIDISCIPLINARY SCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Patients with spontaneous and traumatic intracranial hemorrhage (ICH) are frequently transfused platelets to treat thrombocytopenia, platelet function defects, and reverse antiplatelet drugs. ABO-identical platelet transfusion has been suggested to lead to higher post-transfusion platelet increments compared to major-ABO incompatible transfusion. We hypothesized that patients who received ABO-identical transfusion would have higher post-transfusion platelet increments and superior neurologic outcomes.
Methods: Adults with traumatic or non-traumatic ICH from January 1st 2018 to December 31st 2022 were identified using electronic medical records and international classification of disease (ICD)-10 codes. Patients were excluded if they lacked a platelet count within 24 hours before and within 24 hours after transfusion or if they received multiple platelet transfusions before their platelet count was remeasured. After stratification by ABO-identical, ABO-major incompatible, and ABO-minor incompatible transfusion, post transfusion increments were compared, as were clinical outcomes.
Results: Among 167 patients who received platelet transfusion, 76 (45.5%) received ABO-identical transfusion, 54 (32.3%) received ABO-major incompatible transfusion, and 37 (22.2%) received ABO-minor incompatible transfusion. There were no significant differences in absolute platelet increment between groups. The median increment was 7x109/L for ABO-identical platelets, 10x109/L for ABO-major incompatible platelets, and 11x109/L for ABO-minor incompatible platelets, p = .87. There was no significant difference in the percentage of patients discharged alive with modified Rankin score of 1 or 2 or cerebral performance category 1 or 2 between groups (p = .56 and .39 respectively). After adjusting for confounders in a general linear model there remained no associations between ABO compatibility and platelet increment after transfusion.
Conclusions: Our data support similar efficacy for ABO-identical and ABO-incompatible platelet transfusion in patients with ICH.
期刊介绍：
PLOS ONE is an international, peer-reviewed, open-access, online publication. PLOS ONE welcomes reports on primary research from any scientific discipline. It provides:
* Open-access—freely accessible online, authors retain copyright
* Fast publication times
* Peer review by expert, practicing researchers
* Post-publication tools to indicate quality and impact
* Community-based dialogue on articles
* Worldwide media coverage
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
