Kahan B D, Green D, Ruder A, Ranney D F, Hartz W H, Mittal K K
Surgery. 1975 Feb;77(2):241-8.
Thrombocytopenic patients, who displayed hemostatic disorders and had been previously sensitized by repeated blood transfusions and/or pregnancies, were supported for surgical procedures by platelet transfusions obtained from a single ABO and HL-A matched donor by the use of continuous collection centrifugation. Because of the low incidence of HL-A identical donors, compatibility was assessed by known serological cross-reactivity of the HL-A determinants. In three cases repeated platelet transfusions had excellent in vivo survival, and sensitization could not be detected by a battery of immunological assays. In one case there was immune sensitization and refractoriness to repeated platelet transfusion, as documented by accelerated in vivo destruction of donor and third-party platelets bearing the disparate factor HL-A8. Although serologic tests for lymphocytotoxic and leukoagglutinating antibodies were negative, the patient displayed cellular immunity in leukocyte aggregation and cell-mediated plateletolysis tests. The single donor, continuous collection technique appears to have the technical advantage of rapid, efficient collection and the immunological benefit of a restricted spectrum of allosensitization.
血小板减少症患者表现出止血功能紊乱，且此前因反复输血和/或妊娠而致敏，通过使用连续采集离心机从单一 ABO 和 HL-A 匹配供体获取的血小板输注来支持手术操作。由于 HL-A 相同供体的发生率较低，通过已知的 HL-A 决定簇血清学交叉反应性来评估相容性。在三例患者中，反复输注血小板在体内具有良好的存活率，并且通过一系列免疫测定未检测到致敏现象。在一例患者中，存在免疫致敏和对反复血小板输注的难治性，这表现为带有不同因子 HL-A8 的供体和第三方血小板在体内加速破坏。尽管淋巴细胞毒性和白细胞凝集抗体的血清学检测呈阴性，但该患者在白细胞聚集和细胞介导血小板溶解试验中表现出细胞免疫。单一供体连续采集技术似乎具有快速、高效采集的技术优势以及同种致敏谱受限的免疫学益处。
