Sekiguchi S, Mitani T, Ohnuma M, Katoh T, Ikeda H, Nakase T, Morioka M, Sakurada K, Miyazaki T
Hokkaido Red Cross Blood Center.
Hokkaido Igaku Zasshi. 1988 Jul;63(4):552-61.
Platelets collected from random and multiple donors were as effective on transfusion as those obtained from single donor by platelet pheresis if patients were not alloimmunized. In alloimmunized patients, effects of platelet transfusion were correlated with the HLA-matching grade; 100% effective in A-match, 92% in B-match and 65% in C-match. This correlation was not observed if the patient had infection. The transfusion of A- or B-matched platelets resulted in a lowering or disappearance of HLA antibody activities in most patients. However, the transfusion of C-matched platelets caused increasing or appearance of HLA antibody activities in some patients. The ABO-incompatibility did not show a significant effect on platelet transfusion when anti-A or anti-B antibody activities in donors and antiglobulin tests on patients' red cells were negligible. Non HLA, platelet specific antibodies were produced in some patients and presumed to be participated in the destruction of transfused HLA-matched platelets.
如果患者没有同种免疫,从随机多个供体采集的血小板与通过血小板单采术从单个供体获得的血小板在输血时效果相同。在同种免疫患者中,血小板输注效果与HLA匹配程度相关;A匹配时有效率为100%,B匹配时为92%,C匹配时为65%。如果患者有感染,则未观察到这种相关性。输注A或B匹配的血小板会使大多数患者的HLA抗体活性降低或消失。然而,输注C匹配的血小板会使一些患者的HLA抗体活性增加或出现。当供体中的抗A或抗B抗体活性以及患者红细胞的抗球蛋白试验可忽略不计时,ABO不相容性对血小板输注没有显著影响。一些患者产生了非HLA血小板特异性抗体,并推测其参与了输注的HLA匹配血小板的破坏。