An alloimmunized, thrombocytopenic patient successfully transfused with acid-treated, random-donor platelets.
Alloimmunized, thrombocytopenic patients, refractory to random-donor platelet transfusion, often respond to HLA-identical single-donor platelets. HLA-compatible platelets are expensive, take time to prepare, and donors are sometimes not to be found. We have used random-donor platelets and 'peeled' the HLA-antigen off the platelets, using a modified laboratory method (incubation of platelets with citric acid solution at 0 degrees C). Platelet recovery in two healthy subjects was 72.0% for acid-treated platelets, and 73.5% for untreated control platelets, using 111In-labelled autologous platelets. Survival time (multiple hit) was 6.25 and 7.95 d, respectively. Random-donor platelets that were strongly positive in the crossmatch with serum from a patient became negative after treatment with the acid solution. Furthermore, transfusion of these platelets gave a post-transfusion, platelet-count increment comparable with transfusion of HLA-compatible single-donor platelets.
Shanwell
A
A
Stockholm Blood Transfusion Service, Huddinge, Sweden.
Sallander
S
S
Olsson
I
I
Gulliksson
H
H
Pedajas
I
I
Lerner
R
R
D016913:Blood Component Transfusion / Q000379:methods*; D001792:Blood Platelets / Q000187:drug effects / Q000276:immunology; D002951:Citrates / Q000494:pharmacology; D019343:Citric Acid; D006085:Graft Survival / Q000187:drug effects; D006648:Histocompatibility / Q000187:drug effects; D006801:Humans; D007518:Isoantibodies / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion; D013921:Thrombocytopenia / Q000097:blood / Q000276:immunology / Q000628:therapy*
D002951:Citrates; D007518:Isoantibodies; D019343:Citric Acid