Analysis and prospect of platelet compatible transfusion
10.13303/j.cjbt.issn.1004-549x.2022.11.001
- VernacularTitle:血小板配合性输注的分析和展望
- Author:
Faming ZHU
1
;
Wei MAO
2
;
Zhixin ZHANG
3
Author Information
1. Blood Center of Zhejiang Province, Hangzhou 310052, China
2. Blood Center of Chongqing
3. Red Cross Blood Center of Beijing
- Publication Type:Journal Article
- Keywords:
platelets compatible transfusion;
human leukocyte antigen;
platelet transfusion refractoriness;
allele specific HLA antibodies;
avoidance DSA;
human platelet antigen
- From:
Chinese Journal of Blood Transfusion
2022;35(11):1097-1100
- CountryChina
- Language:Chinese
-
Abstract:
Platelet compatible transfusion can effectively solve the immune mediated platelet transfusion refractoriness (PTR), save platelet resources and improve blood safety. This paper comments and prospects the compatibility modes of HLA, HPA and CD36, HLA antibody titer, antigen immunogenicity and the development of platelet compatible transfusion. The pattern of HLA compatible platelets involves the matching in the alleles, antigens and epitopes levels, respectively, as well as avoidance donor specificity antibody (DSA) method. While setting the mean fluorescence intensity (MFI) threshold of avoidance DSA needs to be explored when using the DSA prediction method. Allele specific HLA antibodies can be found in the patients with PTR. Therefore, the patients and donors should be genotyped for HLA-A, -B loci at high-resolution level in order to avoid allele specific HLA antibodies. The immunogenicity of various antigens or epitopes at HLA-A and -B loci are different. Selecting donor platelets with low antigen expression or low immunogenicity may be a way of HLA compatible platelets. As the probability and type of HPA antibody production are different in the various populations, the approaching of compatibility HPA involves allele matching and avoidance DSA. As to CD36, the compatibility mode mainly refers to avoidance DSA, which means blood donors with CD36 antigen type Ⅰdeficiency are preferentially selected, and then those with CD36 antigen type Ⅱ deficiency. In the future, more attention should be paid to the scale up of database capacity and update of the information construction. The time waiting for compatible platelets transfusion in clinical could be significantly shortened if the requiring and matching are only conducted within the inventory and candidate platelets.
