Thomas’ Hematopoietic Cell Transplantation. Refractoriness to Platelet Transfusion Following Double Valve Replacement in an ITP Patient Who Had Undergone Splenectomy. Both cross-matched PLT and HLA-matched PLT resulted in a similar response for immune-mediated PTR, but HLA-matched PLT was superior for non-immune mediated PTR. Therefore even in a large pool of blood bank donors chances of finding a perfectly matched donor are low. There were no significant differences in the 1‐ to 4‐hour CCIs when comparing random units with HLA‐selected or cross‐match–compatible units. Efficacy of cross-match compatible platelets in multi transfused haemato-oncology patients refractory to platelet transfusion. Boston, Dordrecht, Lancaster: Martinus Nijhoff 1987:1–12.
J Immunol Methods 1980;33:33–44. We identified all patients who received either HLA‐matched or cross‐matched PLTs during a 3‐year period at our medical center. Post-transfusion purpura (PTP): This syndrome is characterized by an abrupt drop in platelet count occurring 7–10 days after transfusion and the presence of platelet-specific antibody(ies). Part of Springer Nature. RESULTS: Selection of platelets with either a complete HLA match or an acceptable HLA mismatch based on genomic typing and DSA information, each predicted 86% successful transfusion responses. On the other hand, the median CCI‐24 for cross‐matched PLT transfusions and HLA‐matched PLT transfusions were 1856 and 5824 (p < 0.001), with a success rate of 28.1 and 54.1% in cases with non‐immune‐mediated PTR, respectively (p = 0.001). Hum Immunol 1982;5:225–31. pp 243-247 | The American Red Cross reference laboratories can provide expert assistance with your most complex serological cases to help ensure positive outcomes for your patients. Nordhagen R, Flaatzen ST Chloroquine removal of HLA-antigens from platelets for the platelet immunofluorescence test. There was also no significant difference when comparing the HLA‐matched and cross‐match–compatible PLT units with each other. Vox Sang 1985;49:340–5. The difference of selection method between cross-matched PLT and HLA-matched PLT may influence the effectiveness of the transfusion. In addition, the American Red Cross National Reference Laboratory for Platelet Serology and some IRLs offer a wide variety of expanded laboratory techniques to investigate and characterize platelet-specific auto- and alloantibodies. Recent studies have reported the utility of human leucocyte antigens (HLA) virtual cross‐matched PLT (HLA‐matched PLT) that is defined as HLA‐A/B matched or no antibody against donor‐specific antigen. Use of cross matching or HLA matching for donor selection is the basis of managing patients refractory to platelet (PLT) transfusion. Platelet transfusion refractoriness in highly immunized beta thalassemia children undergoing stem cell transplantation. Response to random apheresis platelets versus HLA‐selected platelets versus pooled platelets in HLA‐sensitized patients. Efficacy of HLA virtual cross‐matched platelet transfusions for platelet transfusion refractoriness in hematopoietic stem cell transplantation. HLA-matched PLT resulted in a higher response, and episodes of bleeding and splenomegaly were lower by multiple linear regression analysis (Table 1). Grade A matches (4 antigen match) are the best but often are not available. Pegels JG, Bruynes EC, Engelfriet CP, von dem Borne AEG Kr. Overview. Drug-induced thrombocytopenia: Patients become thrombocytopenic during or soon after drug therapy. Platelet serology testing can aid in diagnosing antibody-mediated thrombocytopenia and in investigating the cause of platelet refractoriness. Learn about our remote access options, Centré Hospitalier de l'Université de Montréal, Montréal, Québec, Canada, Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, Minnesota, Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota. The median CCI-24 was 1856/μL for cross-matched PLT and 5824/μL for HLA-matched PLT (p<0.001). and you may need to create a new Wiley Online Library account. Introduction: Cross-matched platelet (cross-matched PLT) transfusions are effective for immune-mediated platelet transfusion refractoriness (PTR). HLA matched platelets can be supplied at the direction of the Australian Red Cross Lifeblood Transfusion Medicine Specialist for the following clinical indications: congenital platelet function disorders such as Bernard-Soulier syndrome, Glanzmanns thrombasthenia or other congenital platelet disorders where development of HLA alloantibodies may make future platelet support very difficult;
Because of changes in patient care, we evaluated the effect of cross matching and HLA matching in patients refractory to PLT transfusion. N Engl J Med 1973;15:760–4. We analyzed 139 cross‐matched PLTs and 102 HLA‐matched PLTs.
HLA Polymorphism Affects Risk of de novo Mutation of dystrophin Gene and Clinical Severity of Duchenne Muscular Dystrophy in a Southern Chinese Population. Please check your email for instructions on resetting your password. Not affiliated Dahlke MB, Weiss KL. Platelet donor selection for HLA‐immunised patients; the impact of donor‐specific HLA antibody levels. Learn about our remote access options, Finnish Red Cross Blood Transfusion Service Helsinki Finland. I. Non-radioactively labeled cell mediated lympholysis. GUIDELINE FOR THE USE OF PLATELET TRANSFUSION CONCENTRATES BASED ON SCIENTIFIC EVIDENCE: UPDATE 2019科学的根拠に基づいた血小板製剤の使用ガイドライン：2019年改訂版. These tests are used to aid in the diagnosis of platelet-related conditions, such as: Platelet crossmatching using the SPRCA technique is widely used to select platelet products for patients who have become refractory. Antibody formation in pregnant women with maternal‐neonatal human platelet antigen mismatch from a hospital in northern Taiwan. The percentage of successful transfusions was 38.1% for cross-matched PLT and 57.8% for HLA-matched PLT, respectively, (p<0.001). Fischer M, Chapman JR, Ting A, Morris PJ. For HLA-mismatched transfusions, the eplet score correlated with CCI and the fraction of successful transfusions, but less well compared to DSA matching. For human platelet antigen (HPA) typing by molecular methods, visit our Molecular Testing page. Ho Heparin, quinine (quinidine) and sulfa drugs are the most frequently studied, but a large number of drugs are known to induce thrombocytopenia. An analysis of the initial episode of the PLT transfusion refractoriness was conducted for each patient. In: Smit Sibinga CTh, Das PC, Engelfriet CP (eds). A randomized trial of leukocyte-depleted platelet transfusion to modify alloimmunization in patients with leukemia. Schiffer CA, Dutcher JP, Aisner J, Hogge D, Wiernik PH, Rully JP. A CCI‐24 ≥ 4500 was considered to be a successful transfusion. Additional crossmatching of phenotyped platelets with patient serum may be needed to circumvent platelet‐specific antibodies of unknown specificity.
Exp Hematol 1981;9:77–83. Platelet serology testing can aid in diagnosing antibody-mediated thrombocytopenia and in investigating the cause of platelet refractoriness. How I do it: platelet support for refractory patients. HLA matched platelets are most often used by patients who have leukaemia (bone marrow Results: Sixteen patients received a total of 241 PLT transfusions; 139 PLT transfusions were cross-matched, and 102 PLT transfusions were HLA-matched.
Also matched platelets from unrelated donors can survive normally in the highly sensitized patient [2–4]. Working off-campus? Such patients can be successfully treated with platelet concentrates from an HLA compatible sibling donor [1]. Vox Sang 1985;48:156–9. The products are supplied after confirmation of cross-matched negative. Number of times cited according to CrossRef: Immunologic Concepts in Transfusion Medicine. The HLA-antigens are coded by a very polymorphic genetic system. In certain clinical situations (NAIT, PTP), it is necessary to transfuse single donor platelets (SDP) from donors who are negative for the high frequency platelet antigen HPA-1a. Exp Hematol 1981;9:84–9. White cells and platelets in blood transfusion. Approach to the Platelet Refractory Patient. How do I … implement diagnostic management teams in transfusion medicine?. I need to know about HLA matched platelets. The usual cause of refractoriness is the production of antibodies to HLA Class I antigens, which are present on the transfused platelets. Murphy MF, Metcalfe P, Thomas H, et al. Duquesnoy RJ, Filip DJ, Rodey GE, Rimm AA, Aster RH. The Kaohsiung Journal of Medical Sciences. Search for other works by this author on: © 2018 by The American Society of Hematology, Copyright ©2020 by American Society of Hematology, 401. R. Kekomäki M.D. HLA services include: HLA Typing Boston, Dordrecht, Lancaster: Martinus Nijhoff 1987:261–7.
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