PMID- 35915764
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220803
IS  - 1999-768X (Print)
IS  - 2070-5204 (Electronic)
IS  - 1999-768X (Linking)
VI  - 37
IP  - 4
DP  - 2022 Jul
TI  - Evaluation of Human Leucocyte Antigen Mediated Platelet Transfusion 
      Refractoriness and Platelet Crossmatching Assay in Patients with Hematologic 
      Disorders.
PG  - e402
LID - 10.5001/omj.2022.81 [doi]
AB  - OBJECTIVES: Platelet refractoriness complicates the platelet transfusion, which 
      is essential for managing thrombocytopenia in patients with hematological 
      disorders. It is associated with adverse clinical outcomes and increased health 
      care costs. We conducted a prospective study to determine the effectiveness of 
      cross-matched compatible platelets in a group of patients refractory to platelets 
      from random donors and to evaluate human leukocyte antigen (HLA)-mediated 
      refractoriness. METHODS: This prospective study was conducted on 40 patients with 
      different hematological disorders requiring platelet transfusions who were 
      refractory to random platelets and presented to the hematology unit of 
      Alexandria's main university hospitals between May 2020 and March 2021. They 
      received 60 ABO-compatible platelet transfusions, either leuco-reduced or random 
      donor platelets, stored for no more than 72 hours. A solid-phase red cell 
      adherence technique (SPRCA) was used for platelet crossmatching. The corrected 
      count increment (CCI) was used to monitor the effectiveness of each platelet 
      transfusion with a cut-off value of 5 x 10(3)/microL at 1 hour and 2.5 x 10(3)/microL at 
      24 hours. Anti-HLA antibodies were assessed using the enzyme-linked immunosorbent 
      assay technique. RESULTS: Out of 60 cross matches, 47 (78.3%) were compatible, 
      and 13 (21.7%) were incompatible. Among 47 compatible results, 30 (63.8%) showed 
      adequate CCI and 17 (36.2%) showed inadequate CCI at 1-hour post-transfusion. 
      Among the incompatible results, 3 (23.1%) had adequate CCI and 10 (76.9%) had 
      inadequate CCI. Significant improvements were found in the mean CCI when 
      comparing cross-matched compatible platelets and incompatible platelets at 1hour 
      or 24 hours (p=0.009 and p < 0.001, respectively). From the 40 studied patients, 
      HLA alloimmunization was present in 18 patients (45.0%) and absent in the 
      remaining 22 patients (55.0%). In the absence of HLA alloimmunization, patients 
      showed significantly better responses at 1 hour and 24 hours (p =0.001 and p 
      =0.015, respectively). There was better sensitivity of platelet crossmatching 
      with random donor platelet concentrates than single donor platelet concentrates. 
      CONCLUSIONS: Platelet crossmatching using SPRCA and HLA screening are effective 
      and rapid tools for better management of patients' refractory to platelet 
      transfusions.
CI  - The OMJ is Published Bimonthly and Copyrighted 2022 by the OMSB.
FAU - Neanaey, Wafaa A
AU  - Neanaey WA
AD  - Clinical Pathology Department, Alexandria University, Alexandria, Egypt.
FAU - Deghady, Akram A
AU  - Deghady AA
AD  - Clinical Pathology Department, Alexandria University, Alexandria, Egypt.
FAU - Nafea, Dalia A
AU  - Nafea DA
AD  - Internal Medicine Department, Hematology Unit, Alexandria University, Alexandria, 
      Egypt.
FAU - Fahmy, Nada M
AU  - Fahmy NM
AD  - Blood bank of Alexandria University Hospitals, Alexandria University, Alexandri, 
      Egypt.
FAU - Gouda, Asmaa M
AU  - Gouda AM
AD  - Clinical Pathology Department, Alexandria University, Alexandria, Egypt.
LA  - eng
PT  - Journal Article
DEP - 20220731
PL  - Oman
TA  - Oman Med J
JT  - Oman medical journal
JID - 101526350
PMC - PMC9243567
OTO - NOTNLM
OT  - Blood Grouping and Crossmatching
OT  - Platelet Transfusion
OT  - Thrombocytopenia
EDAT- 2022/08/03 06:00
MHDA- 2022/08/03 06:01
PMCR- 2022/07/31
CRDT- 2022/08/02 01:49
PHST- 2021/11/28 00:00 [received]
PHST- 2022/02/27 00:00 [accepted]
PHST- 2022/08/02 01:49 [entrez]
PHST- 2022/08/03 06:00 [pubmed]
PHST- 2022/08/03 06:01 [medline]
PHST- 2022/07/31 00:00 [pmc-release]
AID - OMJ-37-04-2100160 [pii]
AID - 10.5001/omj.2022.81 [doi]
PST - epublish
SO  - Oman Med J. 2022 Jul 31;37(4):e402. doi: 10.5001/omj.2022.81. eCollection 2022 
      Jul.