Objective To investigate the therapeutic efficacy of HLA-genotype matched platelet transfusion using a platelet donor database for severe platelet transfusion refractoriness (PTR) caused by HLA antigen-antibody incompatibility. Methods Using real-time quantitative PCR (qPCR) to identify he patient's HLA class I genotype, followed by searching the platelet donor database for matching donors, and selecting highly compatible donors for transfusion. Platelets with higher compatibility levels were prioritized for transfusion recommendations. Results Among the 19 patients studied, 7 patients identified donors with B2U or higher compatibility, 6 patients identified donors with BX or higher compatibility, and 6 patients did not find a suitable donor. The transfusion efficacy was evaluated by calculating the corrected count increment (CCI) 24 hours post-transfusion, and all transfusions were effective. Conclusion The optimal strategy to prevent and treat patients with severe platelet transfusion refractoriness is to ensure patients receive platelet transfusions that are matched to their HLA genes, and this approach significantly enhances transfusion efficacy.
Humans ; Platelet Transfusion/adverse effects* ; HLA Antigens/immunology* ; Male ; Middle Aged ; Female ; Adult ; Blood Platelets/immunology* ; Aged ; Genotype

Objective To identify the sequence variation of human leukocyte antigen(HLA)novel allele A11:193 and to simulate the three-dimensional structure of the protein molecule.Methods A sample with abnormal allele results was found by PCR-SBT sequencing and identified by single allele specific sequencing.The 3D structure of the encoded protein was analyzed by Swiss-Model.Results Compared with HLA-A*11:01:01,which has the highest homology,exon 4 nt 662 of this sample has a base substitution of A→G,and its corresponding codon 197 is changed from CAT to CGT,which is changed from histidine(His)to arginine(Arg).Conclusion A new allele of HLA-A was confirmed.The allele sequence was named HLA-A11:193 by the WHO HLA Factor Nomenclature Committee and the three-dimensional structure of the protein molecule encoded by HLA-A11:193 was simulated.There was no significant difference in the three-dimensional structure of the encoded protein between it and HLA-A*11:01:01.

Objective To identify the sequence variation of human leukocyte antigen(HLA)novel allele A11:193 and to simulate the three-dimensional structure of the protein molecule.Methods A sample with abnormal allele results was found by PCR-SBT sequencing and identified by single allele specific sequencing.The 3D structure of the encoded protein was analyzed by Swiss-Model.Results Compared with HLA-A*11:01:01,which has the highest homology,exon 4 nt 662 of this sample has a base substitution of A→G,and its corresponding codon 197 is changed from CAT to CGT,which is changed from histidine(His)to arginine(Arg).Conclusion A new allele of HLA-A was confirmed.The allele sequence was named HLA-A11:193 by the WHO HLA Factor Nomenclature Committee and the three-dimensional structure of the protein molecule encoded by HLA-A11:193 was simulated.There was no significant difference in the three-dimensional structure of the encoded protein between it and HLA-A*11:01:01.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the positive rate of HLA-Ⅰ or/and HLA-Ⅱ antibody in female blood donors with a history of pregnancy in Shandong region,with an aim of exploring the significance of HLA antibody testing in reducing clinical platelet transfusion adverse reactions,and providing data support for safe blood transfusion and rational use of blood products.Method Flow cytometry microbead method was used to detect HLA-Ⅰ and HLA-Ⅱ antibodies in 186 samples included in this study.Result Among 186 female blood donors with pregnancy history,77 were detected as positive for HLA-Ⅰ class antibodies(41.4％),41 cases were HLA-Ⅱ positive(22.0％),92 cases were positive for HLA-Ⅰ or/and HLA-Ⅱ antibodies(49.5％).Conclusion A preliminary investigation has conducted on the distribution of HLA antibodies among female blood donors with a history of pregnancy in the local area,and the HLA antibody positivity rate is as high as 49.5％.The results of this study provide a certain data basis for the establishment of preventive measures for transfusion immune related complications caused by blood products and HLA antibodies in a reasonable manner.

Objective To investigate the positive rate of HLA-Ⅰ or/and HLA-Ⅱ antibody in female blood donors with a history of pregnancy in Shandong region,with an aim of exploring the significance of HLA antibody testing in reducing clinical platelet transfusion adverse reactions,and providing data support for safe blood transfusion and rational use of blood products.Method Flow cytometry microbead method was used to detect HLA-Ⅰ and HLA-Ⅱ antibodies in 186 samples included in this study.Result Among 186 female blood donors with pregnancy history,77 were detected as positive for HLA-Ⅰ class antibodies(41.4％),41 cases were HLA-Ⅱ positive(22.0％),92 cases were positive for HLA-Ⅰ or/and HLA-Ⅱ antibodies(49.5％).Conclusion A preliminary investigation has conducted on the distribution of HLA antibodies among female blood donors with a history of pregnancy in the local area,and the HLA antibody positivity rate is as high as 49.5％.The results of this study provide a certain data basis for the establishment of preventive measures for transfusion immune related complications caused by blood products and HLA antibodies in a reasonable manner.

OBJECTIVE: To study the polymorphism of human platelet antigen (HPA) system 10 among ethnic Han Chinese from Shandong, China so as to supplement the data of platelet donor bank in the region. METHODS: Peripheral blood samples of platelet donors from the region were genotyped for HPA-10 alleles by PCR-sequence specific primer (PCR-SSP) and direct sequencing. RESULTS: Among 1401 donors, a rare heterozygote carrier of HPA-10w (a+b+) was identified, which gave an allelic frequency of approximately 0.035%. CONCLUSION The detection of rare HPA-10bw antigen allele among ethnic Han Chinese from Shandong is useful for the diagnosis and prevention of neonatal alloimmune thrombocytopenia and post-transfusion purpura in the region.
Alleles ; Antigens, Human Platelet/genetics* ; Asians/genetics* ; Gene Frequency ; Genotype ; Humans ; Infant, Newborn ; Polymorphism, Genetic

OBJECTIVE: To characterize a novel HLA allele, A*24:191, its DNA sequence, MHC modeling structure, and the possible influence of the amino-acid residue variations on the molecule. METHODS: The HLA sequence was determined by Luminex PCR-SSO and PCR-SBT. Its MHC molecular structure and the possible effects of the amino-acid residue variations were modeled and analyzed with Phyre2, RCSB PDB and HistoCheck software. RESULTS: The PCR-SBT revealed the novel A*24:191 differs from A*24:02 in exon 2 at position 256, 265, 270 with G>C, G>C, A>T. The MHC molecular structure prediction showed that, compared with A*24:02, the 62nd residue of A*24:191 changed from the acidic E to a neutral Q, both with the side chain extending outside the α helix pointing forward the groove, (Risler's score, R=2), the 65th changed from the smaller neutral G extending inside the helix to a basic R with a long-chain extending upward outside the helix (R=52), and the 66th changed from the basic K to a neutral N both with a long side chain extending inside the groove (R=31). The above residues are located on the α helix of the α 1 domain which constituting the side wall of the peptide-binding groove. The DSS Score=3.85. From the surface image of the molecule, it can be clearly seen that the variations of the properties, sizes and configurations of the residues caused significant changes in the shape of the surface structure of the α helix. CONCLUSION It suggested that the residue variations are likely to change the peptide binding properties as well as the TCR and antibody binding characteristics of the molecule.
Alleles ; Amino Acid Sequence ; HLA-A Antigens ; Humans ; Peptides ; Protein Binding ; Protein Conformation

Objective    To define the patient characteristics and perioperative management, and to define the mortality and its risk factors after arterial switch operation (ASO). Methods    We conducted a bidirectional cohort study with 571 consecutive patients undergoing ASO from 1997 to 2016 in our hospital. We enrolled patients who underwent ASO before 2012 retrospectively and after 2012 prospectively and followed up all the patients prospectively. Demographic characteristics, clinical information and mortality of these patients were summarized. Joinpoint regression analysis was used to identify the time trend of the overall mortality. Kaplan-Meier survival analysis was used to evaluate the mid- and long-term survival rate after ASO. Cox proportional hazards regression models were used to explore the potential factors associated with mortality. The cumulative incidence of complications after ASO was predicted using competing risk models. Results    Several aspects of patients’ characteristics and perioperative management in our center differed from those in the developed countries. The overall mortality and in-hospital mortality after ASO was 16.3% and 15.1%, respectively. The overall cumulative survival rate at 5, 10 and 15 years after ASO was 83.3%, 82.8% and 82.8%, respectively. A significant decrease of overall mortality from 1997 to 2016 was observed. Independent risk factors of mortality included earlier ASO (1997-2006), single or intramural coronary anatomy and longer cardiopulmonary bypass time. Ten years after ASO, re-intervention, arrhythmia, pulmonary and anastomotic stenosis were the most common complications with a cumulative incidence over 10%. Conclusion    Significant improvements in the results of the ASO were observed and the postoperative mortality rate is close to reports from developed countries. Nonetheless, we have identified the need for further improvement in the early and late postoperative periods after ASO. Pulmonary stenosis, anastomotic stenosis and arrhythmia should be paid attention to during the long-term follow-up after ASO.

Objective: To identify a novel human leukocyte antigen (HLA) B allele in a Chinese Han individual and construct its three-dimensional structure. Methods: The initial HLA genotyping was performed by PCR-sequence-based typing (PCR-SBT). The ambiguous allele was confirmed with single-strand DNA sequencing. The DNA sequence was analyzed to identify the difference between the novel allele and its closest matching allele. Finally, the three-dimensional molecular structure of the novel allele was constructed using a Swiss-Model. Results: One allele of the subject at the HLA-B locus was B*44: 03: 01, whilst the other was a novel allele which differed from the closest matching allele B*51: 01: 01: 01 by nucleotide (nt) 329 A>C in exon 2, resulting in an amino acid change at codon 86 (p.Asn86Thr). Conclusion A novel HLA-B allele has been identified and officially named as HLA-B*51: 159 by the WHO Nomenclature Committee for Factors of the HLA System. The three-dimensional structure of B*51: 159 was simulated.