血小板输注无效患者的供者筛选

Donor Screening Strategy for Patients with Piatelet Transfusion Refractoriness

目的探讨解决血小板输注无效的途径,改善血小板输注效果。方法对12例血小板输注无效患者先进行HLA抗体与HPA抗体检测,然后分别在血小板供者库中找到HLA-I类位点3个以上抗原相合的供者,进行血小板交叉配合试验。结果 12例PTR患者检出HLA抗体阳性共8例,阳性率为66.7%,HPA抗体阳性1例,阳性率为8.3%,HLA抗体合并HPA抗体阳性共3例,阳性率为25.0%。对8例仅有HLA抗体的患者选择HLA-I类位点3个以上抗原相合的供者,其血小板输注有效率为87.5%,对1例有HPA抗体的患者采用血小板交叉配合试验,其血小板输注有效率33.3%。对3例有HLA与HPA联合抗体的患者,选择HLA-I类位点3个以上抗原相合的供者,进行血小板交叉配合试验,其血小板输注有效率为66.7%。结论对PTR患者进行抗体筛查,选择HLA相合的供血者及血小板交叉配合试验十分重要,是解决PTR的有效途径。

Objective To inquiry the approach resolving platelet transfusion refractoriness（PTR）,improve the effi-cacy of platelet transfusion.Methods Antibody of HLA and HPA were first detected in twelve patients with PTR,then more than 3 alleles compatible donors on HLA class I from the platelet donor bank were found and carried through plateletcross-matching ests.Results The positive rate of HLA antibody in patients was 66.7%,the positive rate of HPA ntibodywas 8.3% and the positive rate of HLA antibody combined with HPA antibody was 25.0%.For eight patients withHLA antibody only,more than 3 alleles compatible donors on HLA class I from the platelet donor bank.the efficacy rate ofplatelet transfusion was 87.5%,For one patients with HPA antibody,platelet cross-matching test were adopted,and the effiective of platelet transfusion.For three patients with HLA antibody and HPA antibody, more than 3 alle-les compatible donors on HLA class I from the platelet donor bank were found and carried through platelet cross- matchingtests,the efficacy rate of platelet transfusion was 66.7%.Conclusion It is very important to carry out antibody screening, select platelet donor for HLA compatible and platelet cross-matching tests.It is an effective approach for solving PTR.