ABSTRACT
【Objective】 To search compatible and suitable platelets for platelet transfusion refractoriness (PTR) patient caused by compound antibodies against HLA and CD36. 【Methods】 ELISA method was used to detect the antibody against platelet antigens and the specificity of HLA-I antibody in PTR patients. The specificity of HLA-I antibody and corresponding epitopes of patients were analyzed using MATCH IT! and HLA Matchmaker software. The HLA genotype of both donor and patient was obtained by HLA-SSO method. Compatible or suitable donor platelets for PTR patients were searched through cross-reactive group (CREG) of HLA-I and HLA epitope-matched approach (Eplet). The matching degree was identified using monoclonal antibody-specific immobilization of platelet antigens (MAIPA) and the platelet suspension immunofluores-cence test (PIFT). Finally, the transfusion effect was evaluated according to the corrected count increment (CCI). 【Results】 Compound antibodies against both CD36 and HLA-I antigens were detected in two PTR patients, and their phenotype of CD36 was conformed to be type I deficient. Through LSA testing, high-frequency of HLA -I antibodies was found in these two patients, and the panel reactive antibody in patients 1 and 2 was 56% (54/96) and 53% (51/96), respectively. According to HLA-CREG and Eplet matching strategies, one donor of grade C-matching with patient 1 and one donor of grade D-matching with patient 2 were screened from the CD36 deficiency donor bank, respectively. And the selected donors avoided the antigen of HLA-I antibody epitope. These results of MAIPA and PIFT also confirmed that no immune response was detected between the patient and the donor. And a CCI of >4.5 within 24 hour of transfusion of compatible platelets was obtained in patient 2. 【Conclusion】 For PTR patients caused by HLA and CD36 compound antibodies, a combination strategy including serological cross-matching, HLA-CREG and Eplet approach should be used to select the CD36 deficient donor platelets which evaded the antigen corresponding to HLA-I antibodies and had the compatible HLA epitopes.
ABSTRACT
【Objective】 To discuss the influence of apheresis platelets donation mode transformation, from walk-in to appointment, on apheresis platelets donation, donor retention and donation service quality. 【Methods】 The comparative research method is used to compare the number of apheresis platelets donors, blood donation units, rate of first-time blood donation, rate of repeated blood donation, conversion rate of fixed whole blood donors and satisfaction rate before and after the transformation of donation model. Questionnaires were randomly distributed to apheresis platelets blood donors before and after the transformation to study the evaluation of appointment mode. 【Results】 In comparison with walk-in mode, the number of blood donors after adopting the appointment mode was 30 193, with 41.93% (8 920/21 273) increase; number of blood donations was 119 143, with 93.66% (57 622/61 521) increase; platelet donation was 212 717 treatment units, with 103.12% (107 990/104 727) increase; rate of repeated blood donation was 53.56% (16 172/30 193), with 15.43% increase; the number of first-time donors was 15 949, with 57.93% (5 850/10 099) increase; the conversion rate of fixed whole-blood donors was 37.86% (6 039/15 949), with 8.84% increasement; the satisfaction of appointment mode reached 99.81%, with significantly improved satisfaction with blood donation environment and waiting time. 【Conclusion】 The appointment mode of apheresis platelet donation has a promoting role in the increase of apheresis platelets donation, the improvement of solid blood donors and the quality of apheresis platelets donation services.
ABSTRACT
<p><b>OBJECTIVE</b>It is to study the effect of tripterygium (TW) on the plasma IL-18 content in patients with lupus nephritis (LN) and its treatment value.</p><p><b>METHOD</b>The patients with LN treated with prednisone were divided into active groupand inactive group with active index. The active group was given tripterygium additionally. The changing of plasma IL-18 and release of nephritis were observed after treatment for three months.</p><p><b>RESULT</b>The level of plasma IL-18 lowered down obviously, urinary protein decreased, LN activity index, hematuria and renal function improved.</p><p><b>CONCLUSION</b>Tripterygium caninhibitroduction of plasma IL-18. It has definite treatment value on controlling LN activity.</p>