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Anti‐HLA alloantibodies in surgical patients refractory to platelet transfusion
Author(s) -
Peña Jeremy Ryan A.,
Saidman Susan L.,
Girouard Timothy C.,
Meister Erin,
Dzik Walter H.,
Makar Robert S.
Publication year - 2014
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.23757
Subject(s) - medicine , human leukocyte antigen , refractory (planetary science) , platelet , isoantibodies , platelet transfusion , blood transfusion , immunology , antigen , biology , astrobiology
Alloimmune platelet refractoriness (alloPR) among actively bleeding surgical patients with thrombocytopenia represents a life‐threatening problem. Here we present three cases in which surgical bleeding was complicated by life‐threatening thrombocytopenia and alloPR. We demonstrate that the human leukocyte antigens (HLA) antibodies associated with alloPR are broadly reactive and in high concentration, are not removed by hemodilution, and are not absorbed by transfusion of multiple doses of platelet concentrates. HLA alloPR may be under‐recognized among surgical patients. Research is needed to develop pre‐operative screening methods that will identify patients in need of specialized platelet support using HLA compatible donor products. Am. J. Hematol. 89:E133–E137, 2014. © 2014 Wiley Periodicals, Inc.