title: [An evaluation of platelet transfusion response using HLA crossmatch-compatible donors in patients with platelet refractoriness].
abstract: BACKGROUND
  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.
  
  
  METHODS
  Sixteen patients showing platelet refractoriness to random donor platelets (1 hr corrected count increment [CCI] <7,500/microL/m(2)) and HLA alloimmunization (class I panel reactive antibody >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.
  
  
  RESULTS
  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<0.001), whereas such differences were not observed for those from the second choice donors. Platelet storage time was inversely correlated with CCI values and platelets stored < or =10 hr after collection gave significantly higher CCI values. Neither ABO match nor donor status (related vs unrelated) affected the transfusion effectiveness.
  
  
  CONCLUSIONS
  Effective post-transfusion platelet increment using HLA crossmatch-compatible donors was attained in patients with platelet refractoriness due to HLA antibodies, and this method can be used effectively where HLA-typed platelet donor registry is not available.
authors.affiliation: Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jungwon
authors.initials: J
authors.lastname: Hyun
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Lim
authors.forename: Kyung Deuk
authors.initials: KD
authors.lastname: Park
authors.forename: Bok Youn
authors.initials: BY
authors.lastname: Han
authors.forename: Yang Hyun
authors.initials: YH
authors.lastname: Kim
authors.forename: Kyou Sup
authors.initials: KS
authors.lastname: Han
authors.forename: Myoung Hee
authors.initials: MH
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001788:Blood Grouping and Crossmatching / Q000379:methods*; D002648:Child; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D017713:Platelet Transfusion / Q000379:methods*; D013921:Thrombocytopenia / Q000628:therapy; D013997:Time Factors; D014019:Tissue Donors
chemical_list: D006680:HLA Antigens