Duquesnoy R J, Filip D J, Rodey G E, Rimm A A, Aster R H
Am J Hematol. 1977;2(3):219-26. doi: 10.1002/ajh.2830020303.
A critical factor limiting the availability of histocompatible platelet transfusions for alloimmunized, thrombocytopenic patients is the large pool of HLA-typed donors needed to procure platelets perfectly matched for HLA antigens. We have, therefore, investigated the effectiveness of platelets obtained from donors having lesser degrees of histocompatibility. In 421 transfusions administered to 59 alloimmunized patients who were refractory to "random donor" platelets, it was found that platelets mismatched for 1 or 2 "cross-reactive" HLA antigens were in most instances as effective in increasing circulating platelet levels as perfectly matched platelets. A significant number of patients also responded to platelets from donors selectively mismatched for non-cross-reactive HLA antigens. The latter group had a significantly reduced frequency of the antigen HLA-A2 (13%) in comparison to the total patient population (49%). Use of donors whose HLA antigens are serologically cross-reactive with those of alloimmunized patients provides approximately 10 times as many prospective donors as does selection based on matching for HLA and simplifies the procurement of hemostatically effective platelets for such patients.
限制为同种免疫性血小板减少症患者提供组织相容性血小板输血的一个关键因素是，需要大量经过HLA分型的供者来获取与HLA抗原完全匹配的血小板。因此，我们研究了来自组织相容性程度较低的供者的血小板的有效性。在对59名对“随机供者”血小板难治的同种免疫患者进行的421次输血中，发现与1个或2个“交叉反应性”HLA抗原不匹配的血小板在大多数情况下，在提高循环血小板水平方面与完全匹配的血小板一样有效。相当数量的患者对来自与非交叉反应性HLA抗原选择性不匹配的供者的血小板也有反应。与总患者群体（49%）相比，后一组患者中抗原HLA - A2的频率显著降低（13%）。使用其HLA抗原与同种免疫患者的抗原具有血清学交叉反应性的供者，可为这类患者提供的潜在供者数量是基于HLA匹配选择的大约10倍，并且简化了为这些患者获取具有止血效果的血小板的过程。
