Identification, Prevention and management of platelet refractoriness

Platelet refractoriness can be caused by immunological and non-immunological factors. In non-immunological cases, the source which is usually a disease, should be eliminated. In immunological cases antibodies produced against foreign platelet antigens play a significant role. The aim of this review was to investigate the strategies involved in identifying and preventing immunological platelet refractoriness .

This article reviews the tests used to identify platelet refractoriness for selection of compatible platelets, as well as prevention and management of the disease. This was done by using keywords; Platelet Transfusion, Platelet Refractory, Corrected Count Increment and Alloantibody and their Persian equivalents through scientific database including  Science Direct, PubMed Medline, SID, Scopus and Magiran, and finally among 100 related articles, 66  were selected.

Since the main immunological cause of platelet refractoriness is production of anti-HLA antibodies, screening for these antibodies is very important. Cross-matching and antibody-specificity prediction can also be performed for these patients. In emergencies, plasma replacement, intravenous immunoglobulin injection, and use of certain medications and compounds could be helpful.

Investigating the efficacy of different methods in diagnosis of platelet refractoriness and detection of compatible platelets has a great impact on prevention, treatment and better management of the disease.