Xu Deyi, Sun Chunxia, Yu Lu, He Yunlei, Deng Gang, Zhang Jiwei
The Ningbo Central Blood Station, Ningbo, China.
The Affiliated Hospital of Medical School of Ningbo University, 247 People's Road, Jiangbei District, Ningbo, 315040 Zhejiang Province China.
Indian J Hematol Blood Transfus. 2023 Jan;39(1):123-131. doi: 10.1007/s12288-022-01547-9. Epub 2022 May 26.
The current study aimed at establishing a large-scale platelet donor database with known HPA and HLA genotypes in Ningbo, to provide matched platelets for the clinic and prevent the occurrence of ineffective immune platelet transfusion refractoriness (PTR). The platelet banks of clinical donor wtih HLA-A, HLA-B, HPA1, HPA2, HPA3, HPA4, HPA5, HPA6, HPA10, HPA15 and HPA21 genotyps were established. Meanwile, the platelet gene matching was performed on the donor. It was found that there were phenotype polymorphisms in 1000 donnors with HPA1, HPA2, HPA3, HPA4, HPA5, HPA6, HPA10, HPA15 and HPA21 genotyps, and allel polymorphism distribution in donnors with HPA1, HPA2, HPA3, HPA4, HPA5, HPA6, HPA15, HPA21 genotyps. The frequency of HPA10 was a gene, and not b gene, showing a single linear distribution. The HPA 2, HPA3, HPA15 system were the most polymorphic with three phenotypes: aa, ab, bb. In the HLA-A allele, the highest frequency is A11:01 (24.25%). There were 13 alleles that were greater than 1%, such as A24:02, A02:01, A33:03, and the accumulated frequency reached 96.20%. In the HLA-B allele, the highest gene frequency was B40:01 (13.40%). There were 24 alleles that were greater than 1%, such as B46: 01, B58: 01, B15: 01, and the accumulated frequency reached 91.60%. Platelet antibody cross matching was performed on 100 blood samples from patients with thrombocytopenia after multiple platelet transfusions. The number of consistent samples was 46 (46%). Twenty patients were transfused with platelet cross matching. Among them, 18 patients had obvious improvement in clinical symptoms and good hemostatic effect after transfusion, which was judged to be effective. Platelet donor HPA and HLA-A, B antigen genotyping database provided patients with individual appropriate platelets, and provided the effectiveness of immune platelet infusion ensuring effective platelet transfusion.
本研究旨在建立宁波地区已知人类血小板抗原（HPA）和人类白细胞抗原（HLA）基因型的大规模血小板供者数据库，为临床提供匹配的血小板，预防无效免疫性血小板输注无效（PTR）的发生。建立了具有HLA-A、HLA-B、HPA1、HPA2、HPA3、HPA4、HPA5、HPA6、HPA10、HPA15和HPA21基因型的临床供者血小板库。同时，对供者进行血小板基因匹配。发现在1000名具有HPA1、HPA2、HPA3、HPA4、HPA5、HPA6、HPA10、HPA15和HPA21基因型的供者中存在表型多态性，以及在具有HPA1、HPA2、HPA3、HPA4、HPA5、HPA6、HPA15、HPA21基因型的供者中存在等位基因多态性分布。HPA10的频率为a基因，而非b基因，呈单一线性分布。HPA 2、HPA３、HPA15系统多态性最高，有aa、ab、bb三种表型。在HLA-A等位基因中，频率最高的是A11:01（24.25%）。有13个等位基因频率大于1%，如A24:02、A02:01、A33:03，累积频率达96.20%。在HLA-B等位基因中，基因频率最高的是B40:01（13.40%）。有24个等位基因频率大于1%，如B46: 01、B58: 01、B15: 01，累积频率达91.60%。对100例多次血小板输注后血小板减少患者的血样进行血小板抗体交叉配型。配型一致的样本数为46例（46%）。对20例患者进行了血小板交叉配型输注。其中，18例患者输血后临床症状明显改善，止血效果良好，判断为有效。血小板供者HPA和HLA-A、B抗原基因分型数据库为患者提供了个体化合适的血小板，保证了免疫性血小板输注的有效性，确保了血小板输注的疗效。
