Single donor, HL-A matched platelet transfusions for thrombocytopenic patients undergoing surgery

Thrombocytopenic patients, who displayed hemostatic disorders and had been previously sensitized by repeated blood transfusions and/or pregnancies, were supported for surgical procedures by platelet transfusions obtained from a single ABO and HL-A matched donor by the use of continuous collection ce...

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Bibliographic Details
Published inSurgery Vol. 77; no. 2; p. 241
Main Authors Kahan, B D, Green, D, Ruder, A, Ranney, D F, Hartz, Jr, W H, Mittal, K K
Format Journal Article
LanguageEnglish
Published United States 01.02.1975
Subjects
ABO Blood-Group System
Adult
Blood Platelets - immunology
Blood Transfusion
Cytotoxicity Tests, Immunologic
Female
Histocompatibility Antigens
Histocompatibility Testing
Humans
Leukocytes - immunology
Lymphocyte Activation
Lymphocyte Culture Test, Mixed
Male
Middle Aged
Platelet Aggregation
Splenectomy
Surgical Procedures, Operative
Thrombocytopenia
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Summary:Thrombocytopenic patients, who displayed hemostatic disorders and had been previously sensitized by repeated blood transfusions and/or pregnancies, were supported for surgical procedures by platelet transfusions obtained from a single ABO and HL-A matched donor by the use of continuous collection centrifugation. Because of the low incidence of HL-A identical donors, compatibility was assessed by known serological cross-reactivity of the HL-A determinants. In three cases repeated platelet transfusions had excellent in vivo survival, and sensitization could not be detected by a battery of immunological assays. In one case there was immune sensitization and refractoriness to repeated platelet transfusion, as documented by accelerated in vivo destruction of donor and third-party platelets bearing the disparate factor HL-A8. Although serologic tests for lymphocytotoxic and leukoagglutinating antibodies were negative, the patient displayed cellular immunity in leukocyte aggregation and cell-mediated plateletolysis tests. The single donor, continuous collection technique appears to have the technical advantage of rapid, efficient collection and the immunological benefit of a restricted spectrum of allosensitization.
ISSN:0039-6060