Platelets

Because platelet concentrates contain few red blood cells, compatibility tests prior to transfusion are not necessary. The donor plasma in platelets should be ABO-compatible (but not necessarily group-specific) with the recipient’s red blood cells, a requirement that is even more critical when transfusing neonatal recipients with a smaller blood volume.

Plasma Component Compatibility Table

Rh Compatibility

Immunization to red blood cell antigens may occur because of the presence of trace amounts of red blood cells in platelets. Because of this, when Rh-positive platelets are transfused to females of child-bearing age or younger, Rh immune globulin should be considered to prevent anti-D production.

Pre-transfusion Testing

The patient must be tested for ABO and Rh. The difficulty arises as to whether, once typed, patients require ABO and Rh typing on each admission. Because there are no standards that address this issue,policy typically is set by individual hospital or regional transfusion services.

Background Information

Patient ABO and Rh typing is required because, when possible, ABO-compatible and Rh-specific platelet concentrates are issued. When first tested, an antibody screen is normally done as patients requiring platelets may require red cell transfusions at some point.

Note: ABO-incompatible platelets would be acceptable for transfusion in life-threatening hemorrhage due to thrombocytopenia. A policy should exist in each facility detailing the circumstances and when authorization by appropriate medical personnel is required.