scholarly journals Leukocyte depletion of random single-donor platelet transfusions does not prevent secondary human leukocyte antigen-alloimmunization and refractoriness: a randomized prospective study

Blood ◽  
1995 ◽  
Vol 85 (3) ◽  
pp. 824-828 ◽  
Author(s):  
K Sintnicolaas ◽  
M van Marwijk Kooij ◽  
HC van Prooijen ◽  
BA van Dijk ◽  
WL van Putten ◽  
...  
Keyword(s):  
Human Leukocyte Antigen ◽  
Platelet Transfusion ◽  
Human Leukocyte ◽  
Hematologic Malignancies ◽  
Standard Group ◽  
Hla Antibodies ◽  
Leukocyte Antigen ◽  
Leukocyte Depletion ◽  
Single Donor ◽  
Platelet Transfusions

We studied the value of leukocyte depletion of platelet transfusions for the prevention of secondary human leukocyte antigen (HLA)- alloimmunization in patients with a high-risk of prior immunization induced by pregnancies. Seventy-five female patients with hematologic malignancies (mostly acute leukemia) and a history of pregnancy were randomized to receive either standard random single-donor platelet transfusions (mean leukocytes, 430 x 10(6) per transfusion) or leukocyte-depleted random single-donor platelet transfusions. Leukocyte depletion to less than 5 x 10(6) leukocytes per platelet transfusion (mean leukocytes, 2 x 10(6) per transfusion) was achieved by filtration. Of the 62 evaluable patients, refractoriness to random donor platelets occurred in 41% (14 of 34) of the patients in the standard group and in 29% (8 of 28) of the patients in the filtered group (P = .52); anti-HLA antibodies developed in 43% (9 of 21) of individuals in the standard group and 44% (11 of 25) of cases in the filtered group. The time toward refractoriness and development of anti- HLA antibodies was similar for both groups. We conclude that leukocyte depletion of random single-donor platelet products to less than 5 x 10(6) per transfusion does not reduce the incidence of refractoriness to random donor platelet transfusion because of boostering of anti-HLA antibodies.

scholarly journals Applicability of an instrument to identify human leukocyte antigen-compatible donors for platelet transfusions

2018 ◽  
Vol 40 (4) ◽  
pp. 298-304 ◽  
Author(s):  
Millena Gomes Ferreira ◽  
Fernanda Bernadelli De Vito ◽  
Aline Aparecida Ferreira ◽  
Carolina Bonet Bub ◽  
Fernando Antônio Vinhal dos Santos ◽  
...  
Keyword(s):  
Human Leukocyte Antigen ◽  
Human Leukocyte ◽  
Leukocyte Antigen ◽  
Platelet Transfusions

scholarly journals HLA mismatch direction in cord blood transplantation: impact on outcome and implications for cord blood unit selection

Blood ◽  
2011 ◽  
Vol 118 (14) ◽  
pp. 3969-3978 ◽  
Author(s):  
Cladd E. Stevens ◽  
Carmelita Carrier ◽  
Carol Carpenter ◽  
Dorothy Sung ◽  
Andromachi Scaradavou
Keyword(s):  
New York ◽  
Human Leukocyte Antigen ◽  
Cord Blood ◽  
Cord Blood Transplantation ◽  
Human Leukocyte ◽  
Hematologic Malignancies ◽  
Leukocyte Antigen ◽  
Blood Transplantation ◽  
Cord Blood Unit ◽  
Unrelated Cord Blood

AbstractDonor-recipient human leukocyte antigen mismatch level affects the outcome of unrelated cord blood (CB) transplantation. To identify possible “permissive” mismatches, we examined the relationship between direction of human leukocyte antigen mismatch (“vector”) and transplantation outcomes in 1202 recipients of single CB units from the New York Blood Center National Cord Blood Program treated in United States Centers from 1993-2006. Altogether, 98 donor/patient pairs had only unidirectional mismatches: 58 in the graft-versus-host (GVH) direction only (GVH-O) and 40 in the host-versus-graft or rejection direction only (R-O). Engraftment was faster in patients with GVH-O mismatches compared with those with 1 bidirectional mismatch (hazard ratio [HR] = 1.6, P = .003). In addition, patients with hematologic malignancies given GVH-O grafts had lower transplantation-related mortality (HR = 0.5, P = .062), overall mortality (HR = 0.5, P = .019), and treatment failure (HR = 0.5, P = .016), resulting in outcomes similar to those of matched CB grafts. In contrast, R-O mismatches had slower engraftment, higher graft failure, and higher relapse rates (HR = 2.4, P = .010). Based on our findings, CB search algorithms should be modified to identify unidirectional mismatches. We recommend that transplant centers give priority to GVH-O-mismatched units over other mismatches and avoid selecting R-O mismatches, if possible.

scholarly journals Evaluation of four methods for platelet compatibility testing

Blood ◽  
1987 ◽  
Vol 69 (5) ◽  
pp. 1425-1430
Author(s):  
JG McFarland ◽  
RH Aster
Keyword(s):  
Platelet Transfusion ◽  
Statistical Significance ◽  
51Cr Release ◽  
Hla Antibodies ◽  
Platelet Suspension ◽  
Platelet Recovery ◽  
Single Donor ◽  
Hla Compatibility ◽  
Matched Donor ◽  
Platelet Transfusions

Four platelet compatibility assays were performed on serum and platelet or lymphocyte samples from 38 closely HLA-matched donor/recipient pairs involved in 55 single-donor platelet transfusions. The 22 patients studied were refractory to transfusions of pooled random-donor platelets. Of the four assays (platelet suspension immunofluorescence, PSIFT; 51Cr release; microlymphocytotoxicity; and a monoclonal anti-IgG assay, MAIA), the MAIA was most predictive of platelet transfusion outcome (predictability, 74% for one-hour posttransfusion platelet recovery and 76% for 24-hour recovery). The only other assay to reach statistical significance was the PSIFT (63% predictability for one-hour posttransfusion recovery). The degree of HLA compatibility between donor and recipient (exact matches v those utilizing cross-reactive associations) was unrelated to the ability of the MAIA to predict transfusion results. The MAIA may be capable of differentiating HLA antibodies, ABO antibodies, and platelet-specific antibodies responsible for failure of HLA-matched and selectively mismatched single-donor platelet transfusions.

Evaluation of four methods for platelet compatibility testing

Blood ◽  
1987 ◽  
Vol 69 (5) ◽  
pp. 1425-1430 ◽  
Author(s):  
JG McFarland ◽  
RH Aster
Keyword(s):  
Platelet Transfusion ◽  
Statistical Significance ◽  
51Cr Release ◽  
Hla Antibodies ◽  
Platelet Suspension ◽  
Platelet Recovery ◽  
Single Donor ◽  
Hla Compatibility ◽  
Matched Donor ◽  
Platelet Transfusions

Abstract Four platelet compatibility assays were performed on serum and platelet or lymphocyte samples from 38 closely HLA-matched donor/recipient pairs involved in 55 single-donor platelet transfusions. The 22 patients studied were refractory to transfusions of pooled random-donor platelets. Of the four assays (platelet suspension immunofluorescence, PSIFT; 51Cr release; microlymphocytotoxicity; and a monoclonal anti-IgG assay, MAIA), the MAIA was most predictive of platelet transfusion outcome (predictability, 74% for one-hour posttransfusion platelet recovery and 76% for 24-hour recovery). The only other assay to reach statistical significance was the PSIFT (63% predictability for one-hour posttransfusion recovery). The degree of HLA compatibility between donor and recipient (exact matches v those utilizing cross-reactive associations) was unrelated to the ability of the MAIA to predict transfusion results. The MAIA may be capable of differentiating HLA antibodies, ABO antibodies, and platelet-specific antibodies responsible for failure of HLA-matched and selectively mismatched single-donor platelet transfusions.

scholarly journals A FHIR Human Leukocyte Antigen (HLA) Interface for Platelet Transfusion Support

2017 ◽  
Vol 08 (02) ◽  
pp. 603-611 ◽  
Author(s):  
William Gordon ◽  
Jane Baronas ◽  
William Lane
Keyword(s):  
Human Leukocyte Antigen ◽  
Platelet Transfusion ◽  
Human Leukocyte ◽  
Clinical Impact ◽  
Visualization Tool ◽  
Donor Center ◽  
Hematopoietic Stem ◽  
Leukocyte Antigen ◽  
Future Work ◽  
Reactive Antibody

SummaryPlatelet transfusions are a cornerstone of therapy for patients who develop thrombocytopenia while undergoing Hematopoietic Stem Cell Transplantation (HSCT). Many patients who develop Platelet Transfusion Refractoriness (PTR) require HLA-matched platelets. Identifying these patients early could lead to better utilization of platelets as well as increased platelet counts. We built a SMART on FHIR visualization tool to aid the oncology, blood bank, and blood donor center teams in identifying these patients by showing trends in thrombocytopenia along with a computer generated calculated Panel Reactive Antibody (cPRA) level. To do this, we required a FHIR interface to our HLA database. We describe our methods and outcome for constructing this FHIR interface, as well as the architecture and data flow of HLA data from its proprietary database to the SMART on FHIR environment and application database along with RESTful cPRA web service calculator. Future work will evaluate the clinical impact of this platelet visualization tool and overall success of our FHIR implementation. Citation: Gordon WJ, Baronas J, Lane WJ. A FHIR human leukocyte antigen (HLA) interface for platelet transfusion Support. Appl Clin Inform 2017; 8: 603–611 https://doi.org/10.4338/ACI-2017-01-CR-0010

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