PMID- 31602653
OWN - NLM
STAT- MEDLINE
DCOM- 20200608
LR  - 20200608
IS  - 1537-2995 (Electronic)
IS  - 0041-1132 (Linking)
VI  - 59
IP  - 11
DP  - 2019 Nov
TI  - HLA-matched platelet transfusions are effective only in refractory patients with 
      positive HLA antibody screening.
PG  - 3303-3307
LID - 10.1111/trf.15530 [doi]
AB  - BACKGROUND: Recipients of platelet transfusions with 1-hour corrected count 
      increments (1hCCIs) of 7.5 or less on two subsequent platelet transfusions with 
      random platelets may benefit from human leukocyte antigen (HLA)-matched platelet 
      concentrates. We aimed to quantify the efficacy of HLA-matched platelets 
      concentrates expressed in 1hCCIs. METHODS: We performed a cohort study among 
      consecutive refractory patients who received HLA-matched platelet concentrates in 
      the Netherlands between 1994 and 2017. We performed mixed-model linear regression 
      comparing 1hCCIs after HLA split-antigen-matched transfusions with 1hCCIs after 
      HLA-mismatched transfusions, adjusted for within-patient correlations. A 
      donor-to-patient match was categorized as a split-match if all donor HLA-A and -B 
      antigens were present in the patient as well; that is, donor and patient were HLA 
      identical or compatible. Subgroup analyses were performed for patients with 
      positive or negative HLA antibody screens. Finally, the additional effect of ABO 
      mismatches on 1hCCIs was investigated. RESULTS: The 1hCCI after an HLA-matched 
      transfusion was 14.09 (95% reference interval, 1.13-29.89). This was 1.94 (95% 
      confidence interval [CI], 0.74-3.15) higher than 1hCCI after HLA-mismatched 
      transfusions. In patients with negative HLA antibody screening tests, HLA 
      matching did not affect 1hCCIs. Conditional on HLA matching, 1hCCIs decreased by 
      3.70 (95% CI, -5.22 to -2.18) with major ABO mismatches. CONCLUSION: Matched 
      platelet concentrates yielded maximal 1hCCIs, whereas mismatched transfusions 
      still resulted in adequate increments. There is no indication for HLA-matched 
      platelets in patients with negative antibody screens.
CI  - (c) 2019 AABB.
FAU - Kreuger, Aukje L
AU  - Kreuger AL
AUID- ORCID: 0000-0002-1658-9257
AD  - Center for Clinical Transfusion Research, Sanquin Research, Leiden, The 
      Netherlands.
AD  - Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, 
      The Netherlands.
FAU - Makelburg, Anja B U
AU  - Makelburg ABU
AD  - Unit Transfusion Medicine, Sanquin Blood Bank, Amsterdam, The Netherlands.
AD  - Department of Hematology, University Medical Center Groningen, Groningen, The 
      Netherlands.
FAU - Somers, Judith A E
AU  - Somers JAE
AD  - Unit Transfusion Medicine, Sanquin Blood Bank, Amsterdam, The Netherlands.
AD  - Department of Hematology, Erasmus MC-Daniel Den Hoed Cancer Center, Rotterdam, 
      The Netherlands.
FAU - Tomson, Bert
AU  - Tomson B
AD  - Unit Transfusion Medicine, Sanquin Blood Bank, Amsterdam, The Netherlands.
FAU - van de Watering, Leo M G
AU  - van de Watering LMG
AD  - Unit Transfusion Medicine, Sanquin Blood Bank, Amsterdam, The Netherlands.
FAU - van der Bom, Johanna G
AU  - van der Bom JG
AD  - Center for Clinical Transfusion Research, Sanquin Research, Leiden, The 
      Netherlands.
AD  - Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, 
      The Netherlands.
FAU - van Kraaij, Marian G J
AU  - van Kraaij MGJ
AD  - Center for Clinical Transfusion Research, Sanquin Research, Leiden, The 
      Netherlands.
AD  - Unit Transfusion Medicine, Sanquin Blood Bank, Amsterdam, The Netherlands.
AD  - Unit Donor Affairs, Sanquin Blood Bank, Amsterdam, The Netherlands.
FAU - Weller, Claudia M
AU  - Weller CM
AD  - Unit Transfusion Medicine, Sanquin Blood Bank, Amsterdam, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20191011
PL  - United States
TA  - Transfusion
JT  - Transfusion
JID - 0417360
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Donors
MH  - Cohort Studies
MH  - Female
MH  - HLA Antigens/*immunology
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Isoantibodies/*blood
MH  - Linear Models
MH  - Male
MH  - Middle Aged
MH  - Platelet Count
MH  - *Platelet Transfusion
EDAT- 2019/10/12 06:00
MHDA- 2020/06/09 06:00
CRDT- 2019/10/12 06:00
PHST- 2019/04/15 00:00 [received]
PHST- 2019/07/04 00:00 [revised]
PHST- 2019/07/24 00:00 [accepted]
PHST- 2019/10/12 06:00 [pubmed]
PHST- 2020/06/09 06:00 [medline]
PHST- 2019/10/12 06:00 [entrez]
AID - 10.1111/trf.15530 [doi]
PST - ppublish
SO  - Transfusion. 2019 Nov;59(11):3303-3307. doi: 10.1111/trf.15530. Epub 2019 Oct 11.