An evaluation of platelet transfusion response using HLA crossmatch-compatible donors in patients with platelet refractoriness

• Published in: Taehan Chindan Kŏmsa Ŭihakhoe chi 2009-10, Vol.29 (5), p.481-489
• Main Authors: Hyun, Jungwon, Lim, Young Mi, Park, Kyung Deuk, Han, Bok Youn, Kim, Yang Hyun, Han, Kyou Sup, Park, Myoung Hee
• Format: Article
• Language: Korean
• Subjects: Adolescent; Adult; Aged; Blood Grouping and Crossmatching - methods; Child; Female; HLA Antigens - immunology; Humans; Male; Middle Aged; Platelet Count; Platelet Transfusion - methods; Thrombocytopenia - therapy; Time Factors; Tissue Donors
• ISSN: 1598-6535
• DOI: 10.3343/kjlm.2009.29.5.481

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. 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. 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