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Review
. 2019 Mar 1;151(4):353-363.
doi: 10.1093/ajcp/aqy121.

HLA-Mediated Platelet Refractoriness

Amy E Schmidt  1 , Majed A Refaai  1 , Myra Coppage  1
Affiliations
Review

HLA-Mediated Platelet Refractoriness

Amy E Schmidt et al. Am J Clin Pathol. .

Abstract

Objectives: To provide an overview of the complexities associated with the human leukocyte antigen (HLA)-mediated platelet refractoriness. HLA antibody detection technologies and limitations associated with methodologies are discussed.

Methods: A case scenario and review of relevant literature describing platelet refractoriness are presented, followed by a discussion of HLA antibody testing.

Results: Following diagnosis of HLA-mediated refractoriness, a decision is made regarding the approach to obtain the appropriate platelets. The panel reactive antibodies (PRA) % of the patient, HLA typing, and limitations of the HLA testing should be taken into account when deciding which type of product would be the best option for a given patient.

Conclusions: Following confirmation and review of HLA antibody testing, platelets are ordered based upon the PRA% and approach employed, HLA-matched platelets, antigen restricted platelets, or cross-matched platelets. The platelets are transfused and a posttransfusion increment count is monitored to determine transfusion success.

Keywords: Complement-dependent cytotoxicity test; HLA; HLA antibody; Platelet refractory.

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