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Successful transfusion of platelets “mismatched” for HLA antigens to alloimmunized thrombocytopenic patients
Author(s) -
Duquesnoy René J.,
Filip Donald J.,
Rodey Glenn E.,
Rimm Alfred A.,
Aster Richard H.
Publication year - 1977
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.2830020303
Subject(s) - platelet , immunology , human leukocyte antigen , antigen , medicine , histocompatibility , platelet transfusion , isoantibodies , population , environmental health
A critical factor limiting the availability of histocompatible platelet transfusions for alloimmunized, thrombocytopenic patients is the large pool of HL‐typed donors needed to procure platelets perfectly matched for HLA antigens. We have, therefore, investigated the effectiveness of platelets obtained from donors having lesser degrees of histocompatibility. In 421 transfusions administered to 59 alloimmunized patients who were refractory to “random donor” platelets, it was found that platelets mismatched for 1 or 2 “cross‐reactive” HLA antigens were in most instances as effective in increasing circulating platelet levels as perfectly matched platelets. A significant number of patients also responded to platelets from donors selectively mismatched for non‐cross‐reactive HLA antigens. The latter group had a significantly reduced frequency of the antigen HLA‐A2 (13%) in comparison to the total patient population (49%). Use of donors whose HLA antigens are serologically cross‐reactive with those of alloimmunized patients provides approximately 10 times as many prospective donors as does selection based on matching for HLA and simplifies the procurement of hemostatically effective platelets for such patients.