Analysis of Genotype of HLA/HPA and Antibody Specificity in Platelet Transfusion Refractoriness Patients

Abstract

Objective To analyze the genotype of human leukocyte antigen (HLA)/human platelet antigen (HPA) and the antibody specificity in platelet transfusion refractoriness (PTR) patients caused by HLA antibodies combined with HPA antibodies.Methods From January 2010 to June 2012,a total of 6 patients who had HLA class Ⅰ antibodies and HPA antibodies were selected as research subjects from PTR patients who accepted platelet (PLT) crossmatch in Guangzhou Blood Center.HLA antibodies and antibody of membrane glycoprotein (GP) were measured by enzyme-linked immunosorbent assay (ELISA),and the HLA and HPA1-17 genotype were analyzed by sequence specific primers-polymerase chain reaction (PCR-SSP) method.Then the antibodies specificity was confirmed according to HLA/HPA genotype and the antibodies detecting results using monoclonal antibody immobilization of platelet antigens assay (MAIPA).The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Guangzhou Blood Center.Informed consent was obtained from all participants.Results In these 6 PTR patients,anti-HLA-A * 2,-A * 11 and anti-HLA-B * 40 of HLA-Ⅰ antibodies were common.The highest expression of PLT GP specific antibody was GP Ⅱ b/Ⅲ a,accounting for 83.3％ (5/6).3 patients (50.0％,3/6) had anti-HPA-3a antibody; 2 patients (33.3％,2/6) had anti-HPA-3b antibody; only 1 case (16.7％,1/6) had anti-HPA-5b antibody.Conclusions In clinically,the analysis of HLA/HPA genotype and antibody specificity in PTR patients could help us to avoid PLT transfusion which expresses HLA/HPA antibodies against corresponding antigen,to find the blood donors who have the same HLA/HPA genotypes with patients,to improve the efficacy of PLT transfusion and avoid blood waste. Key words: Platelet antibodies; Platelet transfusion; HLA antigens; Antigens, human platelet