Shanwell A, Sallander S, Olsson I, Gulliksson H, Pedajas I, Lerner R
Stockholm Blood Transfusion Service, Huddinge, Sweden.
Br J Haematol. 1991 Nov;79(3):462-5. doi: 10.1111/j.1365-2141.1991.tb08056.x.
Alloimmunized, thrombocytopenic patients, refractory to random-donor platelet transfusion, often respond to HLA-identical single-donor platelets. HLA-compatible platelets are expensive, take time to prepare, and donors are sometimes not to be found. We have used random-donor platelets and 'peeled' the HLA-antigen off the platelets, using a modified laboratory method (incubation of platelets with citric acid solution at 0 degrees C). Platelet recovery in two healthy subjects was 72.0% for acid-treated platelets, and 73.5% for untreated control platelets, using 111In-labelled autologous platelets. Survival time (multiple hit) was 6.25 and 7.95 d, respectively. Random-donor platelets that were strongly positive in the crossmatch with serum from a patient became negative after treatment with the acid solution. Furthermore, transfusion of these platelets gave a post-transfusion, platelet-count increment comparable with transfusion of HLA-compatible single-donor platelets.
对随机供者血小板输注无效的同种免疫性血小板减少患者，通常对 HLA 相同的单供者血小板有反应。HLA 相容的血小板价格昂贵，制备耗时，且有时找不到供者。我们使用随机供者血小板，并采用一种改良的实验室方法（将血小板与柠檬酸溶液在 0℃孵育）从血小板上去除 HLA 抗原。使用 111In 标记的自体血小板，两名健康受试者中，酸处理血小板的血小板回收率为 72.0%，未处理的对照血小板为 73.5%。存活时间（多次打击）分别为 6.25 天和 7.95 天。与患者血清交叉配血呈强阳性的随机供者血小板，经酸溶液处理后变为阴性。此外，输注这些血小板后的血小板计数增加值与输注 HLA 相容的单供者血小板相当。
