Factors Influencing Transfused Platelet Recovery and Survival, With Special Reference to Antiplatelet Antibody

Abstract

Factors influencing platelet increment, recovery and survival were analyzed in 103 transfusions given to 33 thrombocytopenic patients, with special reference to the antiplatelet antibody which was examined by the mixed passive hemoagglutination method recently developed by Shibata et al., (1976). The results demonstrated that platelet increment, recovery and survival were significantly reduced in the patients with post-transfusion fever or antiplatelet antibody. Platelet recovery seemed to decrease with the increase in the number of HLA mismatched antigens, but the changes in percent recovery among every HLA mismatched grades were not statistically significant. The presence of the antiplatelet antibody rather than the lymphocytotoxic antibody, HLA mismatched grades or post-transfusion fever established the presence of the poorer platelet recovery and survival and the more refractory state. Post-transfusion fever was significantly associated with the presence of antibodies against platelets and/or lymphocytes. Hemorrhage was arrested after transfusion in 81.1% out of the 33 patients that had clinical hemorrhage prior to transfusion, but not in six cases (18.2%), all which had poor platelet recovery and post-transfusion fever. The detection of antiplatelet antibody and platelet cross-match test using the mixed passive hemoagglutination method was of primary importance for selecting the adequate donor for platelet transfusion. Platelet typing must be done in the near future.