TY - JOUR
T1 - Impacts of ABO-incompatible platelet transfusions on platelet recovery and outcomes after intracerebral hemorrhage
AU - Magid-Bernstein, Jessica
AU - Beaman, Charles B.
AU - Carvalho-Poyraz, Fernanda
AU - Boehme, Amelia
AU - Hod, Eldad A.
AU - Francis, Richard O.
AU - Elkind, Mitchell S.V.
AU - Agarwal, Sachin
AU - Park, Soojin
AU - Claassen, Jan
AU - Connolly, E. Sander
AU - Roh, David
N1 - Publisher Copyright:
© 2021 American Society of Hematology
PY - 2021/5/13
Y1 - 2021/5/13
N2 - Acute platelet transfusion after intracerebral hemorrhage (ICH) given in efforts to reverse antiplatelet medication effects and prevent ongoing bleeding does not appear to improve outcome and may be associated with harm. Although the underlying mechanisms are unclear, the influence of ABO-incompatible platelet transfusions on ICH outcomes has not been investigated. We hypothesized that patients with ICH who receive ABO-incompatible platelet transfusions would have worse platelet recovery (using absolute count increment [ACI]) and neurological outcomes (mortality and poor modified Rankin Scale [mRS 4-6]) than those receiving ABO-compatible transfusions. In a single-center cohort of consecutively admitted patients with ICH, we identified 125 patients receiving acute platelet transfusions, of whom 47 (38%) received an ABO-incompatible transfusion. Using quantile regression, we identified an association of ABO-incompatible platelet transfusion with lower platelet recovery (ACI, 2 × 103cells per μL vs 15 × 103cells per μL; adjusted coefficient β, −19; 95% confidence interval [CI], −35.55 to −4.44; P =.01). ABO-incompatible platelet transfusion was also associated with increased odds of mortality (adjusted odds ratio [OR], 2.59; 95% CI, 1.00-6.73; P =.05) and poor mRS (adjusted OR, 3.61; 95% CI, 0.97-13.42; P =.06); however, these estimates were imprecise. Together, these findings suggest the importance of ABO compatibility for platelet transfusions for ICH, but further investigation into the mechanism(s) underlying these observations is required.
AB - Acute platelet transfusion after intracerebral hemorrhage (ICH) given in efforts to reverse antiplatelet medication effects and prevent ongoing bleeding does not appear to improve outcome and may be associated with harm. Although the underlying mechanisms are unclear, the influence of ABO-incompatible platelet transfusions on ICH outcomes has not been investigated. We hypothesized that patients with ICH who receive ABO-incompatible platelet transfusions would have worse platelet recovery (using absolute count increment [ACI]) and neurological outcomes (mortality and poor modified Rankin Scale [mRS 4-6]) than those receiving ABO-compatible transfusions. In a single-center cohort of consecutively admitted patients with ICH, we identified 125 patients receiving acute platelet transfusions, of whom 47 (38%) received an ABO-incompatible transfusion. Using quantile regression, we identified an association of ABO-incompatible platelet transfusion with lower platelet recovery (ACI, 2 × 103cells per μL vs 15 × 103cells per μL; adjusted coefficient β, −19; 95% confidence interval [CI], −35.55 to −4.44; P =.01). ABO-incompatible platelet transfusion was also associated with increased odds of mortality (adjusted odds ratio [OR], 2.59; 95% CI, 1.00-6.73; P =.05) and poor mRS (adjusted OR, 3.61; 95% CI, 0.97-13.42; P =.06); however, these estimates were imprecise. Together, these findings suggest the importance of ABO compatibility for platelet transfusions for ICH, but further investigation into the mechanism(s) underlying these observations is required.
UR - http://www.scopus.com/inward/record.url?scp=85105567721&partnerID=8YFLogxK
U2 - 10.1182/blood.2020008381
DO - 10.1182/blood.2020008381
M3 - Article
C2 - 33649761
AN - SCOPUS:85105567721
SN - 0006-4971
VL - 137
SP - 2699
EP - 2703
JO - Blood
JF - Blood
IS - 19
ER -