An Evaluation of HLA-matched Platelet Transfusion Effect in Patients with Platelet Refractoriness / 대한진단검사의학회지

ABSTRACT

BACKGROUND: Patients with platelet refractoriness as a result of human leukocyte antigen (HLA) alloimmunization can be effectively managed by transfusion of HLA-matched platelets. In this study, we have retrospectively evaluated the effect of HLA-matched platelet transfusion using a hospital based donor pool of 450 HLA typed donors. METHODS: For 17 patients showing platelet refractoriness to random donor platelets [1 hr corrected count increment (CCI) or =7, 500/microliter/m2) was obtained. HLA crossmatch (NIH method) negative patients showed a significantly higher platelet increment compared with crossmatch positive patients (23, 877 vs 10, 823; P=0.000). Although better transfusion effect was obtained in higher grade HLA match of A-B2U by selection of HLA compatible donors according to patients' HLA antibody specificities, an effective platelet increment was obtained in lower grade matches as well. Platelets transfused 24 hours (20, 325 vs 11, 417; P=0.029). CONCLUSIONS: Although many low grade matched donors were selected due to a relatively small size of HLA typed donor pool, effective platelet increments were obtained by selecting platelet donors on the basis of HLA antibody specificity.