Platelets - rh compatibility?

[cardiacqueen]

So, last night I gave my first bag of platelets to a male patient.

While verifying the platelets with my 2nd RN we discovered the platelets (4-6 units from platelet pheresis, single donor) were from an RH-Positive (A+) donor . Our patient was RH-Neg (A-). ran to call the blood bank thinking we had just caught a major boo boo but BB insisted that RH-incompatible platelets were safe to give because platelets do not have RH antigens, only ABO antigens.

This seems weird to me. Research I have read has stated that due to scant amount of RBCs that are present in units of platelets, RH antibody formation may occur, so transfusion of RH positive platelets to RH negative donors should be avoided when possible, especially in childbearing females due to the possibility of hemolytic disease of the newborn in future pregnancies. Article went on to state that the RH neg patient who received RH pos platelets should get a dose of RHOgam to prevent this.

So I'm wondering, what is your facility's blood bank platelet policy? Thanks!

[Rose_Queen, BSN, MSN, RN]

We frequently give platelets with such mismatches. However, to ward off the confusion, each slip attached to the platelets is stamped with "Mismatch okayed by blood bank" with the initials of the person okaying it.

[firstinfamily, RN]

I currently do not know what our facility policy is, but I looked this up and apparently according to the Annuals of Hematology: only a possible Rh reaction can occur with platelets if donor is Rh positive and receipient is Rh negative (this was the case in your pt), this reaction cannot occur in the reverse order or if the donor is Rh negative and the recepient is Rh positive. Very little RBCs are found in platelets, but I guess anything is possible and perhaps this is a time to question the facilities policy if it is not addressed by other means.

[OCNRN63, RN]

We frequently give platelets with such mismatches. However, to ward off the confusion, each slip attached to the platelets is stamped with "Mismatch okayed by blood bank" with the initials of the person okaying it.

​We did the same thing.