Platelet Transfusion Therapy

TLDR

Five patients with bone‑marrow aplasia were refractory to platelet transfusions from random donors. The study examined platelet responses from family members and performed HLA typing of donor and recipient lymphocytes using a cytotoxicity test. Excellent responses occurred with HLA‑identical sibling platelets—three patients responded to one sibling and two to two siblings—without developing cytotoxic antibodies over long‑term transfusion, indicating that HLA typing can predict platelet compatibility.

Abstract

Five patients with bone-marrow aplasia had become refractory to platelet transfusions from random donors. The response to platelets from available family members of each of the patients was then studied. Three patients had excellent responses to platelets from a single sibling, and two each responded to platelets from two siblings. The lymphocytes of the donors and recipients were typed for HL-A antigens by the lymphocyte cytotoxicity test. Genotypic analysis of the phenotypes revealed that the excellent responses occurred with platelets from HL-A identical siblings. The patient's serums exhibited no lymphocyte cytotoxicity against the respective seven HL-A identical siblings whereas cytotoxicity was demonstrated to nine of 11 HL-A nonidentical family members. Three patients have received 8 units of platelets per week for 11, 15, and 24 months from HL-A identical siblings without the development of cytotoxic antibodies. HL-A lymphocyte typing of family members can be used to predict platelet compatibility.