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Notably, recipients of ABO-identical platelets had one-quarter the mortality, fewer mean days of antibiotics and hours in the ICU than patients receiving ABO-mismatched transfusions. Maybe due to the smaller number of patients, these latter differences were not significant (119). Our institution switched to universal ABO-matched platelet and cryoprecipitate transfusion in 2005, UGT1A7 and this approach led to improved clinical outcomes and reduced transfusion requirements in surgical patients (120). Furthermore, this approach has also proven feasible from a blood management and administrative standpoint (121). Table ?Table11 summarizes all findings from trials that were performed by our group, at our institution with regards to ABO matching and platelets transfusions. Table 1 Studies investigating the role of ABO-group matching in platelet transfusions. Alloimmunization to HLA Patients who receive frequent platelet transfusions sometimes become less responsive to platelet transfusion, a phenomenon termed ��refractoriness.�� There are immune-mediated mechanisms of platelet refractoriness and non-immune-mediated mechanisms. Overall, the non-immune platelet removal is more common than immune-mediated removal (122). However, R428 purchase in light of the focus of this review article, we will focus on the immune-mediated mechanisms. The most common reason to develop immune-mediated platelet refractoriness is the development of antibodies to foreign HLA A, B (class I MHC), which are expressed on platelets and most other cell types, or the development of platelet-specific antibodies. Interestingly, in case of the sensitization to HLA antigens, transfusion of leukocyte containing blood products is associated with a higher rate of immunization, and consistently, universal leukoreduction leads to a significant reduction in platelet refractoriness (123) (Figure ?(Figure1).1). This along with others lead to the conclusion that transfusing a small amount of leukocytes with Crizotinib concentration red blood cells or platelets is more immunogenic than the transfused platelets themselves. Our institution��s policy is to transfuse only leukoreduced and ABO-identical platelets, and our internal data suggest that this leads to fewer incidences of platelet refractoriness (