Kekomäki R
Finnish Red Cross Blood Transfusion Service, Helsinki, Finland.
Vox Sang. 1998;74 Suppl 2:359-63. doi: 10.1111/j.1423-0410.1998.tb05443.x.
Refractoriness for platelet transfusion is mostly due to clinical factors but may also be caused by alloimmunization. Use of leukocyte-depleted blood cells for transfusions of patients with hematological diseases has reduced if not eliminated HLA-alloimmunization. HLA-antibodies reduce the survival time of incompatible platelets complicating seriously the platelet transfusion support in at least 5% of patients. If consecutive transfusions of HLA matched platelets also fail without identifiable clinical causes, HPA-alloimmunization may have occurred. Platelets from donors phenotyped for both HLA and HPA may produce good platelet count increments and allow optimal treatment of the basic disease despite broad spectrum alloimmunization. Additional cross-matching of phenotyped platelets with patient serum may be needed to circumvent platelet-specific antibodies of unknown specificity.
血小板输注无效主要归因于临床因素，但也可能由同种免疫引起。对血液系统疾病患者输注去除白细胞的血细胞，即便没有消除HLA同种免疫，也已使其有所减少。HLA抗体缩短了不相容血小板的存活时间，这在至少5%的患者中严重妨碍了血小板输注支持。如果在没有可识别的临床原因的情况下，连续输注HLA匹配的血小板也无效，那么可能发生了HPA同种免疫。对HLA和HPA进行表型分型的供者的血小板，可能会使血小板计数显著增加，并能在广泛的同种免疫情况下对基础疾病进行最佳治疗。可能需要将表型分型的血小板与患者血清进行额外的交叉配型，以规避特异性不明的血小板特异性抗体。
