TY - JOUR
T1 - Postnatal intervention for the treatment of FNAIT
T2 - a systematic review
AU - Baker, Jillian M.
AU - Shehata, Nadine
AU - Bussel, James
AU - Murphy, Michael F.
AU - Greinacher, Andreas
AU - Bakchoul, Tamam
AU - Massey, Edwin
AU - Lieberman, Lani
AU - Landry, Denise
AU - Tanael, Susano
AU - Arnold, Donald M.
AU - Baidya, Shoma
AU - Bertrand, Gerald
AU - Kjaer, Mette
AU - Kaplan, Cécile
AU - Kjeldsen-Kragh, Jens
AU - Oepkes, Dick
AU - Savoia, Helen
AU - Ryan, Greg
AU - Hume, Heather
AU - International Collaboration for Transfusion Medicine Guidelines (ICTMG)
PY - 2019
Y1 - 2019
N2 -
Objective: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is associated with life-threatening bleeding. This systematic review of postnatal management of FNAIT examined transfusion of human platelet antigen (HPA) selected or unselected platelets, and/or IVIg on platelet increments, hemorrhage and mortality. Study design: MEDLINE, EMBASE and Cochrane searches were conducted until 11 May 2018. Result: Of 754 neonates, 382 received platelet transfusions (51%). HPA-selected platelets resulted in higher platelet increments and longer response times than HPA-unselected platelets. However, unselected platelets generally led to sufficient platelet increments to 30 × 10
9
/L, a level above which intracranial hemorrhage or other life-threatening bleeding rarely occurred. Platelet increments were not improved with the addition of IVIg to platelet transfusion. Conclusion: Overall, HPA-selected platelet transfusions were more effective than HPA-unselected platelets but unselected platelets were often effective enough to achieve clinical goals. Available studies do not clearly demonstrate a benefit for addition of IVIg to platelet transfusion.
AB -
Objective: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is associated with life-threatening bleeding. This systematic review of postnatal management of FNAIT examined transfusion of human platelet antigen (HPA) selected or unselected platelets, and/or IVIg on platelet increments, hemorrhage and mortality. Study design: MEDLINE, EMBASE and Cochrane searches were conducted until 11 May 2018. Result: Of 754 neonates, 382 received platelet transfusions (51%). HPA-selected platelets resulted in higher platelet increments and longer response times than HPA-unselected platelets. However, unselected platelets generally led to sufficient platelet increments to 30 × 10
9
/L, a level above which intracranial hemorrhage or other life-threatening bleeding rarely occurred. Platelet increments were not improved with the addition of IVIg to platelet transfusion. Conclusion: Overall, HPA-selected platelet transfusions were more effective than HPA-unselected platelets but unselected platelets were often effective enough to achieve clinical goals. Available studies do not clearly demonstrate a benefit for addition of IVIg to platelet transfusion.
U2 - 10.1038/s41372-019-0360-7
DO - 10.1038/s41372-019-0360-7
M3 - Review article
C2 - 30971767
AN - SCOPUS:85064195873
SN - 0743-8346
VL - 39
SP - 1329
EP - 1339
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 10
ER -
