A review article recently published in Life highlights current and emerging techniques for platelet transfusions, a crucial treatment option for patients with fetal and neonatal alloimmune thrombocytopenia (FNAIT) and other forms of thrombocytopenia.
For patients with FNAIT, platelet transfusions can be a life-saving option for treating low platelet counts and managing bleeding. Platelet transfusions can be administered either during pregnancy via intrauterine transfusions or after pregnancy. However, intrauterine transfusions are used less frequently due to an increased risk of complications.
What is thrombocytopenia?
Thrombocytopenia in fetal and neonatal alloimmune thrombocytopenia (FNAIT) refers to an abnormally low number of platelets in the fetus or newborn as a result of an immune reaction. This occurs when the mother’s immune system produces antibodies that target the fetal platelets, typically due to a mismatch in human platelet antigens (HPAs) between the mother and fetus. The maternal antibodies cross the placenta and attack the fetal platelets, leading to their destruction.
In the United States, apheresis, the process by which the platelets are isolated from other blood components, is the preferred method of transfusion. Over the past few years, though, studies have begun to support the use of whole blood-derived platelets as well.
Read more about FNAIT treatment and care
Bacterial contamination is a concern when it comes to platelet transfusions, the authors explained. Currently, the United States Food and Drug Administration (FDA) supports the use of ultraviolet light exposure to target pathogens. The implementation of this technology remains limited, however, due to the high cost and low shelf-life of the product.
In terms of storage, several strategies may help to improve the longevity of platelets including the use of a specialized nutrient solution called platelet additive solution. While cold storage, cryopreservation and freeze-drying are also potential techniques, further research will be needed before they become standard practice.
Researchers have also been investigating synthetic platelets since the 1950s, the authors said. If successful, synthetic platelets have the potential to combat issues related to supply, particularly in areas prone to platelet shortages.
“Moving forward, integrating evidence-based dosing with technological advances and diversified inventories will be crucial for balancing safety, efficacy, and supply stability in transfusion medicine,” the study concluded.
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