Abstract
Author(s): Anisha Navkudkar
Introduction: Platelet refractoriness is the failure to achieve an acceptable increment in platelet count following platelet transfusion at least on two occasions. It is often multifactorial and is divided broadly into non-immune and immune causes. Immune platelet refractoriness primarily due to HLA alloimmunization poses a major challenge in platelet transfusion support which can be dealt with HLA matched or crossmatched platelets. Another alternative is to give platelets matched at HLA- epitope level.
Platelet transfusion refractoriness is failure to achieve desired level of platelet counts in patients following platelet transfusions. Immune platelet refractoriness remains a challenging problem in platelet transfusion therapy. Patients who are refractory as a result of HLA alloimmunization are given HLA-matched or cross matched platelets. But the HLA matched donors can be potential candidates for stem cell harvest in future and patients can develop antibodies to minor antigens causing graft rejection. Another alternative is to provide platelets from donors matched at HLAepitope level.
This is based on the concept that, HLA antibodies are produced for epitopes that can be structurally defined as eplets, which are present on different HLA alleles. We report here three patients who responded to HLA-epitope matched platelet transfusions from unrelated healthy donors. Duquesnoy antigen match grade for the three patients were B1X, D and D, respectively.
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