Korean Red Cross HLA-Matched Platelet Donor Registry / 대한수혈학회지

BACKGROUND: Transfusion of HLA-matched platelets is required when development of platelet refractoriness occurs after repeated platelet transfusion. This study was conducted to establish a HLA-matched platelet donor registry to supply matched platelets to patients who develop platelet refractoriness. METHODS: HLA-matched platelet donors were recruited among plateletpheresis donors. HLA-A and HLA-B antigen types of recruited donors were tested using a polymerase chain reaction-sequence specific oligonucleotide probe method. RESULTS: A total of 1,029 plateletpheresis donors were recruited. HLA-A and HLA-B antigen frequencies of recruited donors were similar to those of previously reported HLA antigen frequencies of Koreans. During the study period, a patient with platelet refractoriness recovered after receiving six units of HLA-matched platelets. CONCLUSION: During this study 1,029 donors were registered as HLA-matched platelet donors and a patient with platelet refractoriness received HLA-matched platelets using this registry. Supply of HLA-matched platelets will be facilitated by continuous expansion of the number of registered HLA-matched platelet donors, development of a program for management and searching for HLA-matched donors, and establishment of a request-supply system between hospitals and the Korean Red Cross through further studies.

Study on the Promotion of HLA-matched Platelet Supply in Korea / 대한수혈학회지

BACKGROUND: Platelet transfusion refractoriness can develop in patients after multiple transfusions of platelets. Once patients develop platelet refractoriness caused by immunological factors, HLA-matched platelet transfusion is required. However, there is no system to supply HLA-matched platelets in Korea. This study was performed to find way to promote the HLA-matched platelet supply in Korea. METHODS: The status of platelets supply in Korea and the frequency of platelet refractoriness in four university hospitals during 2005 were analyzed. It was obtained that the number of ordered and positive cases for the anti-platelet antibody, HLA antibody screening, and Panel Reactive Antibody test among inpatients of hematological malignancies. And the means to use the HLA-A, B data of unrelated bone marrow donors was searched. RESULTS: Platelet supply increased annually and totally 1,558,395 units were supplied in 2005, from Korean Red Cross blood centers. The frequency of platelet transfusion refractoriness was 12.4%, among them 10.4% showed anti-platelet or anti-HLA antibodies positive. A revision of the related law was required to use the HLA data of unrelated bone marrow donors. CONCLUSION: Immunological factors were observed in about 10% of patients with platelet transfusion refractoriness. HLA-matched platelet could be widely available if the HLA-typed donor registry is established in the Korean Red Cross after the revision of the related law.

An Evaluation of Platelet Transfusion Response Using HLA Crossmatch-compatible Donors in Patients with Platelet Refractoriness / 대한진단검사의학회지

BACKGROUND: Majority of immune-mediated platelet refractoriness is caused by HLA alloimmunization and can be effectively managed by HLA-matched platelet transfusions. However, HLA class I-typed large-sized donor registry has not been well established in Korea. We evaluated the effectiveness of platelet transfusion using HLA crossmatch-compatible donors without HLA typing. METHODS: Sixteen patients showing platelet refractoriness to random donor platelets (1 hr corrected count increment [CCI] 60%) were crossmatched with 78 platelet apheresis-eligible donors using National Institute of Health (NIH) and anti-human globulin (AHG) lymphocytotoxicity methods. NIH negative/AHG negative and NIH negative/AHG positive donors were selected as best and second choice donors, respectively. RESULTS: Eleven patients (11/16, 69%) could find NIH-crossmatch negative donors and 27 donors (27/78, 35%) belonged to the best donors. To 8 patients, 32 apheresis platelet products from 19 donors were transfused. The mean 1 hr and 24 hr CCI values from the best donors were significantly higher than those from random donors (17,893 vs 2,358, P=0.003; 8,292 vs -614, P<0.001), whereas such differences were not observed for those from the second choice donors. Platelet storage time was inversely correlated with CCI values and platelets stored < or =10 hr after collection gave significantly higher CCI values. Neither ABO match nor donor status (related vs unrelated) affected the transfusion effectiveness. CONCLUSIONS: Effective post-transfusion platelet increment using HLA crossmatch-compatible donors was attained in patients with platelet refractoriness due to HLA antibodies, and this method can be used effectively where HLA-typed platelet donor registry is not available.