Clinical Aspects and Typing of Platelet Alloantigens

• Published in: Vox sanguinis 1998-06, Vol.74 (S2), p.345-354
• Main Authors: Kroll, H., Kiefel, V., Santoso, S.
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antigens, Human Platelet - analysis; Antigens, Human Platelet - genetics; Antigens, Human Platelet - immunology; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Diseases of mother, fetus and pregnancy; Female; Fetal Diseases - immunology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Genotype; Gynecology. Andrology. Obstetrics; Histocompatibility Testing - methods; HLA Antigens - genetics; HLA Antigens - immunology; Humans; Immunity, Maternally-Acquired; Immunization, Passive; Immunohematology; Infant, Newborn; Isoantibodies - biosynthesis; Isoantibodies - immunology; Male; Medical sciences; Nucleic Acid Hybridization; Phenotype; Platelet immunology; Platelet Transfusion - adverse effects; Polymorphism, Genetic; Polymorphism, Restriction Fragment Length; Pregnancy; Pregnancy. Fetus. Placenta; Serologic Tests; Syndrome; Thrombocytopenia - congenital; Thrombocytopenia - epidemiology; Thrombocytopenia - immunology; Transfusion Reaction; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0042-9007; 1423-0410
• DOI: 10.1111/j.1423-0410.1998.tb05441.x

Platelet alloantigens can induce the formation of corresponding alloantibodies when exposed to phenotypically negative individuals. These antibodies are responsible for fetal and neonatal alloimmune thrombocytopenia, posttransfusion purpura, passive alloimmune thrombocytopenia and transplantation‐ associated thrombocytopenia and may contribute to platelet transfusion refractoriness together with HLA antibodies. Besides antibody detection laboratory diagnosis of the clinical syndromes requires alloantigen typing. Furthermore, typed platelet donors are a prerequisite for effective platelet transfusion therapy. Different techniques for phenotyping are well established and easy to perform but they rely on the availability of antisera. Since the molecular genetic background of the clinically most relevant alloantigens has been elucidated during the last years various genotyping methods have been applied to the platelet membrane polymorphisms and thus facilitated widespread platelet alloantigen typing. Generation of antibodies from phage display libraries and of lymphoblastoid cell lines from donors with all genetic variants will allow further developments.