Postnatal intervention for the treatment of FNAIT: a systematic review Academic Article uri icon

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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 × 109/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.

authors

  • Baker, Jillian M
  • Shehata, Nadine
  • Bussel, James
  • Murphy, Michael F
  • Greinacher, Andreas
  • Bakchoul, Tamam
  • Massey, Edwin
  • Lieberman, Lani
  • Landry, Denise
  • Tanael, Susano
  • Arnold, Donald
  • Baidya, Shoma
  • Bertrand, Gerald
  • Kjaer, Mette
  • Kaplan, Cécile
  • Kjeldsen-Kragh, Jens
  • Oepkes, Dick
  • Savoia, Helen
  • Ryan, Greg
  • Hume, Heather

publication date

  • October 2019