From the Guidelines
Individuals with a positive blood group (Rh positive) can receive platelets from all blood groups, including A+, A-, B+, B-, AB+, AB-, O+, and O-, although ABO-matched platelets are preferred when available to minimize the risk of minor reactions and improve transfusion efficacy. This is because platelet transfusions are generally not affected by the ABO or Rh blood group compatibility that is crucial for red blood cell transfusions, as platelets have minimal expression of blood group antigens compared to red blood cells, making them less likely to trigger immune reactions based on blood type 1. However, platelets do carry some blood group antigens, and plasma in platelet products contains antibodies that could potentially react with the recipient's red blood cells.
Key Considerations
- Platelet products are labeled with ABO and Rh typing and are tested for all required transfusion-transmitted diseases 1.
- Incompatible plasma from platelet transfusions can put patients, particularly children, at risk of hemolysis, but the occurrence of clinically significant hemolysis is unusual in adult recipients 1.
- ABO-compatible products should be provided whenever possible, although inventory issues occasionally preclude this 1.
- For emergency situations where matched platelets aren't available, any blood group's platelets can be used for A positive recipients with minimal risk of serious adverse reactions.
Clinical Practice
In clinical practice, the preference for ABO-matched platelets is based on reducing the risk of minor reactions and improving transfusion efficacy, rather than a strict requirement for compatibility 1. The use of platelet additive solutions can also help reduce the amount of plasma infused to plasma-incompatible recipients, further minimizing the risk of adverse reactions 1.
From the Research
Blood Groups Compatible for Platelet Donation to Rh Positive Individuals
- Individuals with Rh positive blood group can receive platelets from donors with the following blood groups:
- ABO-identical blood group 2, 3
- ABO-minor incompatible blood group, although this may pose a risk of acute hemolytic reaction 2, 3
- RhD positive donors, as transfusion of platelets from RhD positive donors to RhD negative patients is considered effective and safe, but may be associated with a low rate of anti-D alloimmunization 2, 4, 5
- It is worth noting that the prevention of D alloimmunization is recommended only for women of childbearing age 2
- The importance of ABO blood group system compatibility in platelet transfusion is a subject of ongoing debate, and there is presently limited data and no consensus on the best approach for managing ABO compatibility in platelet transfusions 3
Considerations for Platelet Transfusion
- Platelet ABO antigens that are incompatible with recipient ABO antibodies may have accelerated clearance from circulation and result in lower count increments 5
- ABO antibodies that are passively transferred from donor plasma may result in hemolysis of recipient red blood cells 5
- Alloimmunization to the RhD antigen may occur when platelets obtained from RhD-positive donors are transfused to RhD-negative recipients 5