Desensitization in allergic transfusion reactions: Evidence from the Trial to Reduce Alloimmunization to Platelets

摘要

Allergic transfusion reactions (ATRs) occur in up to 3% of platelet (PLT) transfusions, are underreported, and range in severity from mild itching and hives to fatal anaphylaxis. Clinical data have broadly defined factors that may be involved, such as a pathogenic role for plasma. Retrospective data of plasma reduction maneuvers to prevent ATRs to blood products are confounded by selection bias: patients always receive unmanipulated PLTs before being switched to volume-reduced or washed PLTs after ATRs. An individual's risk of ATRs might decrease with increasing numbers of PLT transfusions, independent of PLT product manipulation. Thus, plasma reduction may temporally coincide with, but not cause, a reduction in ATR risk.