A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Platelet donor selection for HLA-immunised patients; the impact of donor-specific HLA antibody levels
Tekijät: Linjama T, Niittyvuopio R, Tuimala J, Pyorala M, Rintala H, Rimpilainen J, Kauppila M, Perasaari J, Juvonen E
Kustantaja: WILEY
Julkaisuvuosi: 2017
Lehti:Transfusion Medicine
Tietokannassa oleva lehden nimiTRANSFUSION MEDICINE
Lehden akronyymi: TRANSFUSION MED
Vuosikerta: 27
Numero: 5
Aloitussivu: 375
Lopetussivu: 383
Sivujen määrä: 9
ISSN: 0958-7578
eISSN: 1365-3148
DOI: https://doi.org/10.1111/tme.12412
Tiivistelmä
BackgroundApproximately 20% of patients with a recurrently poor platelet transfusion increment show human leukocyte antigen (HLA) alloantibodies. The aim of this study was to analyse the impact of mean fluorescence intensity (MFI) levels of donor-specific HLA antibodies and the feasibility of the HLAMatchmaker algorithm in donor selection.Study design and methodsA total of 270 HLA-typed platelet transfusion responses of 40 patients were included in the study. The patients' immunisation status was determined with Luminex-based methods, and HLA alloantibody strengths were defined as the MFI. For the Matchmaker eplet matching, the HLA-ABC Eplet Matching Version 2.1 was used.ResultsIn 62% of the 270 transfusions, HLA antibodies against the transfused platelets were present, with a median cumulative MFI level of 2026 (range: 299-29203). In multivariate analysis, a cumulative MFI level higher than 1000 emerged as an independent risk factor for a poor platelet transfusion increment, along with infection and the age of the product.ConclusionThe HLAMatchmaker algorithm alone is not a sufficient tool for donor selection. Donor selection based primarily on the levels of donor-specific HLA antibodies is a preferable practice.
BackgroundApproximately 20% of patients with a recurrently poor platelet transfusion increment show human leukocyte antigen (HLA) alloantibodies. The aim of this study was to analyse the impact of mean fluorescence intensity (MFI) levels of donor-specific HLA antibodies and the feasibility of the HLAMatchmaker algorithm in donor selection.Study design and methodsA total of 270 HLA-typed platelet transfusion responses of 40 patients were included in the study. The patients' immunisation status was determined with Luminex-based methods, and HLA alloantibody strengths were defined as the MFI. For the Matchmaker eplet matching, the HLA-ABC Eplet Matching Version 2.1 was used.ResultsIn 62% of the 270 transfusions, HLA antibodies against the transfused platelets were present, with a median cumulative MFI level of 2026 (range: 299-29203). In multivariate analysis, a cumulative MFI level higher than 1000 emerged as an independent risk factor for a poor platelet transfusion increment, along with infection and the age of the product.ConclusionThe HLAMatchmaker algorithm alone is not a sufficient tool for donor selection. Donor selection based primarily on the levels of donor-specific HLA antibodies is a preferable practice.
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