Yam P, Petz L D, Scott E P, Santos S
Br J Haematol. 1984 Jun;57(2):337-47.
Refractoriness to random-donor platelets as a result of alloimmunization remains a major problem in long-term platelet transfusion therapy despite the use of HLA-matched platelets. We have therefore studied the use of two methods for detection of platelet associated IgG as platelet crossmatch tests for the selection of platelet donors. These methods use radiolabelled staphylococcal protein A (125I-SPA) and peroxidase anti-peroxidase (PAP), respectively. One hundred and ten crossmatch tests using 125I-SPA were performed retrospectively in 18 alloimmunized patients. The results indicated that the predictive value of a positive or a negative test was 87%; the sensitivity was 73% and the specificity was 95%. Results with the PAP test were similar. The HLA types were known for 48 donor-recipient pairs. With few exceptions, there was a correlation between the results of the platelet crossmatch tests and the effectiveness of platelet transfusion regardless of the degree of HLA match. These results indicate that platelet crossmatch tests may be valuable even when closely HLA matched donors are not available. A large-scale prospective study is warranted, particularly in highly immunized patients.
尽管使用了 HLA 匹配的血小板，但同种免疫导致的对随机供者血小板的难治性仍是长期血小板输血治疗中的一个主要问题。因此，我们研究了两种检测血小板相关 IgG 的方法，作为血小板交叉配型试验以选择血小板供者。这些方法分别使用放射性标记的葡萄球菌蛋白 A（125I-SPA）和过氧化物酶抗过氧化物酶（PAP）。对 18 例同种免疫患者回顾性地进行了 110 次使用 125I-SPA 的交叉配型试验。结果表明，阳性或阴性试验的预测值为 87%；敏感性为 73%，特异性为 95%。PAP 试验的结果相似。已知 48 对供者 - 受者的 HLA 类型。除少数例外，无论 HLA 匹配程度如何，血小板交叉配型试验结果与血小板输血效果之间存在相关性。这些结果表明，即使没有 HLA 紧密匹配的供者，血小板交叉配型试验也可能有价值。有必要进行大规模的前瞻性研究，特别是在高度免疫的患者中。
