Abstract
ABSTRACTObjective To described the allele and haplotype frequencies of human leukocyte antigen genes at the -A, -B loci and human platelet antigen genes for human platelet antigen systems 1 to 9, 11 and 15 in blood.Methods We included 867 healthy unrelated volunteer donors who donated platelets between January 2011 and December 2014. Microarray genotyping was performed using a BeadChip microarray. Medium resolution typing of the human leukocyte antigen at loci A and B was carried out using sequence-specific oligonucleotide probe hybridization. We used multivariate analysis and our human leukocyte antigen population was compared to data from the United States national bone marrow donor program. Human platelet antigen results were compared to a literature review and data from around the world.Results Our human leukocyte antigen haplotype results were more similar to those of hispanics, followed by caucasians. Likewise, our human platelet antigen sample is more similar to those of Argentina, Rio Grande do Sul and Italy.Conclusion This was the first article that discusses human platelet antigen and human leukocyte antigen data together. Rare genotypes or antibody associations can make patient management difficult. A blood bank with genotyped donors allows for optimal transfusion and can contribute to better results. Our information can serve as basis for a database of platelet antigen polymorphisms.
Highlights
Platelets are anucleated cells, shaped like a discoid lens, which can reach 3-5μm at their greatest diameter.[1] to red and white blood cells, platelets express many antigens on their surface, which may give rise to immunological issues and hinder the therapeutic effects of a platelet transfusion.[2]. Human leukocyte antigens (HLA) are glycoproteins (GP) expressed on the surface of nucleated cells, which have a role in tissue rejection
In a thrombocytopenic patient, platelets are often transfused as a prophylactic treatment before starting any invasive procedure.[7]. Platelet refractoriness to transfusion is a lack of adequate post-transfusion platelet count increment, which can be calculated by a formula such as, e.g., corrected count increment or percent platelet recovery
It can be as frequent as 47.4% in Argentina, 45.7% in Paraná Mulato or 61.2% in the Chinese population.[15]. The data corroborate a previous study in which HLA-A*02 was frequent in Jordanian and five major population groups living in the United States.[16,17] In the Registro Nacional de Doadores de Medula Óssea (REDOME) HLA-A*02 is the most frequent among different Brazilian ethnicities.[18]. Rodrigues et al, analyzed the HLA gene frequencies in 366 polytransfused patients, from different regions in Brazil, and found the same result.[19]
Summary
Platelets are anucleated cells, shaped like a discoid lens, which can reach 3-5μm at their greatest diameter.[1]. Human platelet antigens (HPA) result from single nucleotide polymorphisms (SNPs) in the genes that encode GP expressed on platelet surface membranes They can form specific antigens that elicit antibodies through exposure to a different platelet.[2]. In a thrombocytopenic patient, platelets are often transfused as a prophylactic treatment before starting any invasive procedure.[7] Platelet refractoriness to transfusion is a lack of adequate post-transfusion platelet count increment, which can be calculated by a formula such as, e.g., corrected count increment or percent platelet recovery It is established after two sequential transfusions using fresh and ABO-identical platelets, from a randomized donor.[8] Clinically, refractoriness to platelet transfusion was associated with significantly higher costs, longer lengths of stay, delayed bleeding and poor outcomes following bone marrow transplant for acute myeloid leukemia.[8,9]
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