McManigal S, Sims K L
Department of Pathology, Creighton University Medical Center at Saint Joseph Hospital, Omaha, Nebraska 68131, USA.
Am J Clin Pathol. 1999 Feb;111(2):202-6. doi: 10.1093/ajcp/111.2.202.
Transfusion of ABO-incompatible platelets to a cardiac surgery patients resulted in acute intravascular hemolysis complicated by ventricular tachycardia. Nine similar cases with significant morbidity or mortality have been reported in similar settings. Five fatalities caused by transfusion of ABO-incompatible platelet products have been reported to the US Food and Drug Administration during the last 4 years. Non-group O patients, particularly those with small plasma volumes, receiving multiple non-group specific platelets in a short time are at risk for intravascular hemolysis caused by passively infused anti-A1 or anti-B. To prevent intravascular hemolysis in such at-risk patients, the indications for platelet transfusion must be continually assessed. If transfusion of ABO-incompatible platelet products is necessary, consideration should be given to minimizing the accompanying plasma via further concentration of the platelets or by saline washing of platelet products.
给一名心脏手术患者输注ABO血型不相容的血小板导致急性血管内溶血，并并发室性心动过速。在类似情况下已报告了9例具有显著发病率或死亡率的类似病例。在过去4年中，美国食品药品监督管理局已收到5例因输注ABO血型不相容的血小板制品导致死亡的报告。非O型患者，尤其是血浆量少的患者，短时间内接受多次非血型特异性血小板有因被动输注抗A1或抗B而发生血管内溶血的风险。为防止此类高危患者发生血管内溶血，必须持续评估血小板输注的指征。如果有必要输注ABO血型不相容的血小板制品，应考虑通过进一步浓缩血小板或用生理盐水洗涤血小板制品来尽量减少伴随的血浆。
