The relationship between donor-recipient lymphocytotoxicity and the transfusion response using HLA-matched platelet concentrates.

Matching donor-recipient pairs for HLA antigens provides a logical starting point for selecting platelet donors for thrombocytopenic recipients who have demonstrated refractoriness to pooled random donor platelet transfusions. However, not all recipients achieve a compatible transfusion response with platelets selected by HLA type, indicating that additional selection methods are required. Because of studies indicating that a positive lymphocyte cross-match assay between recipient serum (antibody) and donor lymphocytes predict acute renal allograft rejection, it was hoped that this assay might be useful in predicting the platelet transfusion response for alloimmunized patients. The data herein indicate that the results of this assay in no way correlate with the platelet transfusion response. The lymphocyte cross-match would seem to be helpful in the selection of donors where known HLA antigen mismatches occur between donor and recipient. However, even in this situation, no correlation was observed between the transfusion response and donor-recipient lymphocytotoxicity reaction. Clearly additional assays are needed for the selection of compatible donors from those matched by HLA antigens.