Single donor, HL-A matched platelet transfusions for thrombocytopenic patients undergoing surgery.
Thrombocytopenic patients, who displayed hemostatic disorders and had been previously sensitized by repeated blood transfusions and/or pregnancies, were supported for surgical procedures by platelet transfusions obtained from a single ABO and HL-A matched donor by the use of continuous collection centrifugation. Because of the low incidence of HL-A identical donors, compatibility was assessed by known serological cross-reactivity of the HL-A determinants. In three cases repeated platelet transfusions had excellent in vivo survival, and sensitization could not be detected by a battery of immunological assays. In one case there was immune sensitization and refractoriness to repeated platelet transfusion, as documented by accelerated in vivo destruction of donor and third-party platelets bearing the disparate factor HL-A8. Although serologic tests for lymphocytotoxic and leukoagglutinating antibodies were negative, the patient displayed cellular immunity in leukocyte aggregation and cell-mediated plateletolysis tests. The single donor, continuous collection technique appears to have the technical advantage of rapid, efficient collection and the immunological benefit of a restricted spectrum of allosensitization.
D000017:ABO Blood-Group System; D000328:Adult; D001792:Blood Platelets / Q000276:immunology*; D001803:Blood Transfusion; D003601:Cytotoxicity Tests, Immunologic; D005260:Female; D006649:Histocompatibility Antigens; D006650:Histocompatibility Testing; D006801:Humans; D007962:Leukocytes / Q000276:immunology; D008213:Lymphocyte Activation; D007959:Lymphocyte Culture Test, Mixed; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation; D013156:Splenectomy; D013514:Surgical Procedures, Operative; D013921:Thrombocytopenia
D000017:ABO Blood-Group System; D006649:Histocompatibility Antigens