PMID- 35171984
OWN - NLM
STAT- MEDLINE
DCOM- 20221003
LR  - 20221019
IS  - 1543-2165 (Electronic)
IS  - 0003-9985 (Linking)
VI  - 146
IP  - 10
DP  - 2022 Oct 1
TI  - Use of Human Leukocyte Antigen (HLA)-Incompatible Platelet Units in HLA 
      Platelet-Refractory Patients With Limited Number of or Low-Level HLA 
      Donor-Specific Antibodies Results in Permissive Transfusions.
PG  - 1243-1251
LID - 10.5858/arpa.2021-0051-OA [doi]
AB  - CONTEXT.-: In human leukocyte antigen (HLA)-mediated alloimmune platelet 
      refractoriness, HLA-incompatible platelets may produce adequate posttransfusion 
      corrected count increment ("permissive transfusion") and increase the donor pool. 
      OBJECTIVE.-: To determine if a lower number of or low-level anti-HLA 
      donor-specific antibodies (DSAs) predict permissive transfusion and could be used 
      to prioritize platelet selection. DESIGN.-: We categorized platelets administered 
      from 2016 to 2018 as HLA-compatible or HLA-incompatible based on presence of DSAs 
      against the donor unit. We further divided HLA-incompatible units based on the 
      number of DSAs and the level of DSAs (measured by mean fluorescence intensity 
      [MFI]), where cumulative MFI >/=6000 defines high-level DSA. We compared 
      posttransfusion corrected count increments (CCIs) and transfusion reactions among 
      these transfusions. RESULTS.-: Of 279 HLA-selected units transfused into 26 
      platelet-refractory patients, we resorted to using 39 HLA-incompatible units 
      (14%). Posttransfusion CCI and transfusion reaction frequency were similar among 
      units targeted by 1 or low-level DSAs and HLA-compatible units. Units targeted by 
      >/=2 distinct or high-level DSAs produced lower CCIs. Regardless of ABO 
      compatibility, similarly HLA-categorized units yielded comparable CCIs and 
      comparable frequency of transfusion reactions. CONCLUSIONS.-: HLA-incompatible 
      platelets transfused across 1 or low-level DSAs were commonly permissive, whereas 
      those transfused across >/=2 DSAs or high levels of DSA (MFI >/=6000) were 
      nonpermissive. The use of such donor units offers transfusion services 
      alternative platelet units for support of platelet-refractory patients.
FAU - Sullivan, Jensyn Cone
AU  - Sullivan JC
AD  - From the Department of Pathology, Tufts Medical Center, Boston, Massachusetts 
      (Cone Sullivan).
FAU - Pena, Jeremy Ryan
AU  - Pena JR
AD  - From the Department of Pathology, Beth Israel Deaconess Medical Center, Boston, 
      Massachusetts (Pena).
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Arch Pathol Lab Med
JT  - Archives of pathology & laboratory medicine
JID - 7607091
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Antibodies
MH  - Blood Platelets
MH  - HLA Antigens
MH  - Humans
MH  - *Platelet Transfusion
MH  - Tissue Donors
MH  - *Transfusion Reaction
EDAT- 2022/02/17 06:00
MHDA- 2022/10/04 06:00
CRDT- 2022/02/16 17:12
PHST- 2021/09/27 00:00 [accepted]
PHST- 2022/02/17 06:00 [pubmed]
PHST- 2022/10/04 06:00 [medline]
PHST- 2022/02/16 17:12 [entrez]
AID - 477900 [pii]
AID - 10.5858/arpa.2021-0051-OA [doi]
PST - ppublish
SO  - Arch Pathol Lab Med. 2022 Oct 1;146(10):1243-1251. doi: 
      10.5858/arpa.2021-0051-OA.