Is it always necessary to provide Rh(D) negative platelets to a patient with anti-D?

A Medical Director of a transfusion service asks if it is always necessary to provide Rh(D) negative platelets to patients who have made anti-D. Because there is such a small amount of red blood cells in an apheresis unit, any hemolysis would be clinically insignificant, although after numerous units there is a theoretical risk of a hemolytic reaction. At this time the Director’s institution uses only apheresis platelets and current policy is to give only Rh(D) negative platelets to patients with anti-D. The Director notes that it would be advantageous to have more flexibility in unit selection, especially during platelet shortages.

Editors’ Note: The Editors agree that the risk of risk of hemolysis is extremely low, but there may be a risk of increasing the anti-D titer.

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