What do you do when a patient doesn’t respond to platelet transfusions? Pat Kopko shows us a clear pathway to quicker success!
Dr. Pat Kopko
- HLA-matched platelets
- Crossmatched platelets
- HLA antigen-negative platelets
But which is “better?”
Clinicians and blood bankers alike often struggle to find the “best” answer to getting a product that will work well for a refractory patient, without waiting for days to do it! Dr. Kopko has a wealth of experience that includes her history of being both a hospital transfusion service medical director as well as a medical director for a large blood center, so she clearly understands the issue from both hospital and blood center perspectives. Dealing with platelet refractoriness can be complicated, but Pat outlines her strategy to get a product with maximum benefit to the patient as quickly as possible. In fact, you may find that the quickest way to get an effective platelet product in a refractory patient may not be the option you might have thought! Her views on HLA-matched platelets and their utility in modern platelet transfusion practice may also surprise you!
Dr. Pat Kopko
- HLA-matched platelets
- Crossmatched platelets
- HLA antigen-negative platelets
But which is “better?”
Clinicians and blood bankers alike often struggle to find the “best” answer to getting a product that will work well for a refractory patient, without waiting for days to do it! Dr. Kopko has a wealth of experience that includes her history of being both a hospital transfusion service medical director as well as a medical director for a large blood center, so she clearly understands the issue from both hospital and blood center perspectives. Dealing with platelet refractoriness can be complicated, but Pat outlines her strategy to get a product with maximum benefit to the patient as quickly as possible. In fact, you may find that the quickest way to get an effective platelet product in a refractory patient may not be the option you might have thought! Her views on HLA-matched platelets and their utility in modern platelet transfusion practice may also surprise you!
About My Guest:
Dr. Pat Kopko is a graduate of the Loma Linda University School of Medicine in Loma Linda, CA. She did a residency in anatomic and clinical pathology at Loma Linda, followed by a transfusion medicine fellowship at Cedars-Sinai Medical Center in Los Angeles. She is currently Professor of Pathology at the University of California, San Diego, where she serves as Director of Transfusion Medicine and Associate Director of the Immunogenetics and Transplantation Laboratory. Dr Kopko’s research interests center around transfusion reactions, particularly Transfusion-Related Acute Lung Injury (TRALI), currently the leading cause of transfusion-related mortality in the United States. She has published extensively on TRALI and other topics, including platelet refractoriness, transfusion in ABO-incompatible HPC transplantation, and blood transfusion practices.
Enjoyed this podcast very much. Refractory platelet issues are obviously not well understood. All the senerios that you mentioned occur regularly at my hoapital.
At our blood bank we do not do HLA testing. So the information about which product is better and easier to get was quite helpful.
Thanks for the thoughts! I’m glad the podcast was helpful to you!
Great presentation of this issue which is misunderstood and mismanaged by many in the Blood Bank community. I have already referenced my team to Dr Kopko’s paper in Transfusion, now another great resource in understanding this issue.
Thanks, Anne! Dr. Kopko is awesome, and she did a great job. I’m glad it’s helpful to you.
Thank you very much for the great website. I really really like your lectures with great information!!!
Thank you for saying that! I’m honored that you enjoy the site.
Great podcasts! Please keep them coming!
Sandy, I don’t know how I missed this comment! I’m very glad you found the podcasts and that you enjoyed this one with my friend Dr. Kopko. I am always working on these things, so more are definitely on the way!
I found the information about crossmatched platelets very interesting. I wonder if I would be able to get more information about this procedure? As I canvass my hospitals, I find that this procedure is not common?
Jennifer, there are many published resources. One of my favorites, which summarizes the three main methods of providing platelets for patients who are refractory, was actually written by Dr. Kopko (the star of that episode) and three other authors. It is called “Methods for the selection of platelet products for alloimmune-refractory patients,” and the reference is TRANSFUSION 2015;55:235–244. It’s a great article, and I think you will find it helpful.
As a pathology resident who gonna to give a presentation on PLT refractory in 3 wks, I found it more complicated than my own limited practice to deal with the sequence to order lab tests and give PLT products. This podcast gave me a clear and confident answer to the tough questions. Dr Kopko’s also had a great summary regarding our daily practice. The paper is a good reference. Thank you very much!
Tianle, thanks for listening! Dr. Kopko is brilliant, and I love her practical approach in this podcast, too (and by the way, I would call her brilliant even if she wasn’t a great friend of mine!). I’m so glad this was helpful to you.
Joe
Dr. Joe,
when patient had already multiple platelet transfusion, can HPA be simply done with the present sample,how about the donors platelet, will it affect the patient HPA type interpretation?
Well, I’m not totally sure what you are asking me! Can you clarify? If you are talking about testing the patient for HPA (Human Platelet Antigens), we usually don’t need to do that in the short term. Dr. Kopko was speaking more about testing for and dealing with anti-HPA antibodies rather than the antigens themselves.
-Joe
This is probably the first time i totally understood the problem with platelet refractoriness and the possible options that we have in order to deal with this issue!
I would also like to point out the fact that Dr.Kopko talked very clearly and she made herself understood in a very interesting way….I didn’t have to look to the transcprit of this episode at all!She must be not only a great doctor but also a great teacher in blood banking-transfusion medicine…Just like you Joe!
Dr. Kopko is brilliant, Yannis, and I’m glad this episode was useful to you!
-Joe
Thank you so much for this interview podcast, very informative and learned a bunch!