Forest Stefanie K, Hod Eldad A
Department of Pathology and Cell Biology, Columbia University Medical Center, New York-Presbyterian Hospital, 630 West 168th Street, VC 14-239, New York, NY 10032, USA.
Department of Pathology and Cell Biology, Columbia University Medical Center, New York-Presbyterian Hospital, 630 West 168th Street, P&S 14-434, New York, NY 10032, USA.
Hematol Oncol Clin North Am. 2016 Jun;30(3):665-77. doi: 10.1016/j.hoc.2016.01.008. Epub 2016 Apr 5.
Platelet refractoriness occurs when there is an inadequate response to platelet transfusions, which typically has nonimmune causes, but is also associated with alloantibodies to human leukocyte antigens (HLAs) and/or human platelet antigens. Immune-mediated platelet refractoriness is suggested when a 10-minute to 1-hour corrected count increment of less than 5 × 10(9)/L is observed after 2 sequential transfusions using ABO-identical, freshest available platelets. When these antibodies are identified, one of 3 strategies should be used for identifying compatible platelet units: HLA matching, crossmatching, and antibody specificity prediction. These strategies seem to offer similar results in terms of posttransfusion platelet increments.
当对血小板输注的反应不足时，就会出现血小板输注无效，其通常由非免疫原因引起，但也与针对人类白细胞抗原（HLA）和/或人类血小板抗原的同种抗体有关。当使用ABO血型相同、最新鲜的血小板进行2次连续输注后，观察到10分钟至1小时的校正计数增加值小于5×10⁹/L时，则提示存在免疫介导的血小板输注无效。当识别出这些抗体时，应采用三种策略之一来识别相容的血小板单位：HLA配型、交叉配型和抗体特异性预测。就输血后血小板增加值而言，这些策略似乎能提供相似的结果。
