Postnatal intervention for the treatment of FNAIT: a systematic review

Forskningsoutput: TidskriftsbidragÖversiktsartikel

Abstract

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.

Detaljer

Författare
  • Jillian M. Baker
  • Nadine Shehata
  • James Bussel
  • Michael F. Murphy
  • Andreas Greinacher
  • Tamam Bakchoul
  • Edwin Massey
  • Lani Lieberman
  • Denise Landry
  • Susano Tanael
  • Donald M. Arnold
  • Shoma Baidya
  • Gerald Bertrand
  • Mette Kjaer
  • Cécile Kaplan
  • Jens Kjeldsen-Kragh
  • Dick Oepkes
  • Helen Savoia
  • Greg Ryan
  • Heather Hume
  • International Collaboration for Transfusion Medicine Guidelines (ICTMG)
Enheter & grupper
Externa organisationer
  • Hospital for Sick Children, Toronto
  • Mount Sinai Hospital of University of Toronto
  • Canadian Blood Services
  • Weill Cornell Medicine
  • University of Oxford
  • University Medicine Greifswald
  • University Hospital of Tubingen
  • International Blood Group Reference Laboratory
  • University of Toronto
  • Australian Red Cross Blood Service
  • French Blood Services of Brittany
  • Finnmark Hospital Trust
  • University Hospital of North Norway
  • Institut National de la Transfusion Sanguine (INTS)
  • Regional Laboratories Region Skåne
  • Leiden University Medical Centre
  • Royal Children's Hospital, Melbourne
  • University of Montreal, Canada
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Hematologi
Originalspråkengelska
Sidor (från-till)1329-1339
TidskriftJournal of Perinatology
Volym39
Utgåva nummer10
Tidigt onlinedatum2019
StatusPublished - 2019
PublikationskategoriForskning
Peer review utfördJa