title: [Platelet allo-antibodies identification strategies for preventing and managing platelet refractoriness].
abstract: Platelet refractoriness is a serious complication for patients receiving recurrent platelet transfusions, which can be explained by non-immune and immune causes. Human Leukocyte Antigens (HLA) allo-immunization, especially against HLA class I, is the major cause for immune platelet refractoriness. To a lesser extent, allo-antibodies against specific Human Platelet Antigen (HPA) are also involved. Pregnancy, transplantation and previous transfusions can lead to allo-immune reaction against platelet antigens. After transfusion, platelet count is decreased by accelerated platelet destruction related to antibodies fixation on incompatible platelet antigens. New laboratory tests for allo-antibodies identification were developed to improve sensibility and specificity, especially with the LUMINEX(®) technology. The good use and interpretation of these antibodies assays can improve strategies for platelet refractoriness prevention and management with a patient adapted response. Compatible platelets units can be selected according to their identity with recipient typing or immune compatibility regarding HLA or HPA antibodies or HLA epitope compatibility. Prospective studies are needed to further confirm the clinical benefit of new allo-antibodies identification methods and consensus strategies for immune platelet refractoriness management.
authors.affiliation: Laboratoire d'immunogénétique et d'immunologie plaquettaire, EFS-Alpes Méditerranée, 149, boulevard Baille, 13005 Marseille, France. Electronic address: agnes.basire@efs.sante.fr.
authors.forename: A
authors.initials: A
authors.lastname: Basire
authors.affiliation: Laboratoire d'immunogénétique et d'immunologie plaquettaire, EFS-Alpes Méditerranée, 149, boulevard Baille, 13005 Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Picard
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology; D000911:Antibodies, Monoclonal / Q000276:immunology; D016824:Antigens, Human Platelet / Q000235:genetics / Q000276:immunology*; D001792:Blood Platelets / Q000276:immunology*; D003429:Cross Reactions; D003601:Cytotoxicity Tests, Immunologic; D005260:Female; D005434:Flow Cytometry; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007114:Immunization; D007118:Immunoassay / Q000379:methods*; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D047589:Leukocyte Reduction Procedures; D007983:Lewis Blood Group Antigens / Q000276:immunology; D008297:Male; D008863:Microspheres; D010980:Platelet Membrane Glycoproteins / Q000235:genetics / Q000276:immunology*; D017713:Platelet Transfusion / Q000009:adverse effects; D011110:Polymorphism, Genetic; D011247:Pregnancy / Q000276:immunology; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D013921:Thrombocytopenia / Q000209:etiology / Q000276:immunology* / Q000517:prevention & control / Q000628:therapy; D014181:Transplantation Immunology
chemical_list: D000017:ABO Blood-Group System; D000911:Antibodies, Monoclonal; D016824:Antigens, Human Platelet; D006680:HLA Antigens; D007518:Isoantibodies; D007983:Lewis Blood Group Antigens; D010980:Platelet Membrane Glycoproteins; D011933:Reagent Kits, Diagnostic
keywords: Allo-immunisation; Allo-immunization; Antibodies; Anticorps; Diagnosis; Diagnostic; HLA; HPA; Inefficacité plaquettaire; LUMINEX(®); Plaquettes; Platelet; Platelet refractoriness; Transfusion; État réfractaire