title: Low-level HLA antibodies do not predict platelet transfusion failure in TRAP study participants.
abstract: In the Trial to Reduce Alloimmunization to Platelets (TRAP) study, 101 of 530 participants became refractory to platelet transfusions without evidence of HLA or human platelet antigen (HPA) antibodies. We used a more sensitive bead-based assay to detect and quantify HLA antibodies and a qualitative solid-phase enzyme-linked immunosorbet assay for HPA to determine whether low-level antibodies could predict refractoriness in longitudinal panels from 170 lymphocytotoxicity assay (LCA)(-) and 20 LCA(+) TRAP participants. All TRAP recipients who previously tested LCA(+) were HLA antibody(+), using the bead-based system. Levels of HLA or HPA antibodies did not predict refractoriness among LCA(-) recipients, although higher levels of HLA antibodies were associated with refractoriness among LCA(+) recipients. These data demonstrate that weak to moderate HLA antibody levels detectable by modern binding assays are not associated with platelet refractoriness.
authors: Blood Systems Research Institute, San Francisco, CA, USA. rjackman@bloodsystems.org
authors: Rachael P
authors: RP
authors: Jackman
authors: Xutao
authors: X
authors: Deng
authors: Douglas
authors: D
authors: Bolgiano
authors: Mila
authors: M
authors: Lebedeva
authors: John W
authors: JW
authors: Heitman
authors: Michael P
authors: MP
authors: Busch
authors: Sherrill J
authors: SJ
authors: Slichter
authors: Philip J
authors: PJ
authors: Norris
mesh_terms: D000906:Antibodies / Q000097:blood* / Q000276:immunology; D016824:Antigens, Human Platelet / Q000276:immunology*; D001792:Blood Platelets / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D017713:Platelet Transfusion
chemical_list: D000906:Antibodies; D016824:Antigens, Human Platelet; D006680:HLA Antigens
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