8 research outputs found
An Evaluation of Platelet Transfusion Response Using HLA Crossmatch-compatible Donors in Patients with Platelet Refractoriness
Background : Majority of immune-mediated platelet refractoriness is caused by HLA alloimmunization and can be effectively managed by HLA-matched platelet transfusions. However, HLA class I-typed large-sized donor registry has not been well established in Korea. We evaluated the effectiveness of platelet transfusion using HLA crossmatch-compatible donors without HLA typing. Methods : Sixteen patients showing platelet refractoriness to random donor platelets (1 hr corrected count increment [CCI] 60%) were crossmatched with 78 platelet apheresis-eligible donors using National Institute of Health (NIH) and anti-human globulin (AHG) lymphocytotoxicity methods. NIH negative/AHG negative and NIH negative/AHG positive donors were selected as best and second choice donors, respectively. Results : Eleven patients (11/16, 69%) could find NIH-crossmatch negative donors and 27 donors (27/78, 35%) belonged to the best donors. To 8 patients, 32 apheresis platelet products from 19 donors were transfused. The mean 1 hr and 24 hr CCI values from the best donors were significantly higher than those from random donors (17,893 vs 2,358, P=0.003; 8,292 vs -614, P<0.001), whereas such differences were not observed for those from the second choice donors. Platelet storage time was inversely correlated with CCI values and platelets stored :! 10 hr after collection gave significantly higher CCI values. Neither ABO match nor donor status (related vs; unrelated) affected the transfusion effectiveness. Conclusions : Effective post-transfusion platelet increment using HLA crossmatch-compatible donors was attained in patients with platelet refractoriness due to HLA antibodies, and this method can be used effectively where HLA-typed platelet donor registry is not available.
λ°°κ²½ : λ©΄μνμ μμΈμ νμνλΆμμ¦μ λλΆλΆμ HLA λμ’
λ©΄μλ°μμ μν΄ μΌκΈ°λλ©°, HLA μ ν© νμν μνλ‘ ν¨κ³Όμ μΈ νμν μ¦κ°λ₯Ό κΈ°λν μ μλ€. HLA μ ν© νμν 곡κΈμ μν΄μλ HLA class I νμνλ³κ²μ¬κ° λμ΄ μλ λκ·λͺ¨μ ννμ λ±λ‘μ λκ° νμνμ§λ§ κ΅λ΄μμλ μ΄λ° μ λκ° μ ν립λμ΄ μμ§ μλ€. λ³Έ μ°κ΅¬μμλ HLA νμνλ³κ²μ¬λ₯Ό νμ§ μκ³ HLA
κ΅μ°¨μν μ ν©ν ννμλ‘λΆν°μ νμν μνν¨κ³Όλ₯Ό νκ°νκ³ μ νμλ€.
λ°©λ² : μμνν νμνμ λν΄ νμνλΆμμ¦(1μκ° corrected count increment [CCI] 60%)μ λ³΄μΈ 16λͺ
μ νμμ λν΄ νμν μ±λΆμ±μ§μ΄ κ°λ₯ν 78λͺ
μ ννμμ μΈν¬λ
μ±κ²μ¬λ²μ μ΄μ©ν TμΈν¬ κ΅μ°¨μν(National Institute of Healthλ² λ° anti-human
globulinλ², NIHλ² λ° AHGλ²)μ μννμλ€. NIHλ² μμ±/AHGλ² μμ±μΈ κ²½μ° μ΅μ μ ννμλ‘, NIHλ² μμ±/AHGλ² μμ±μΈ κ²½μ° μ°¨μ μ ννμλ‘ μ μ νμλ€.
κ²°κ³Ό : 11λͺ
μ νμ(11/16, 69%)κ° NIH κ΅μ°¨μν μμ±μΈ ννμλ₯Ό μ°Ύμ μ μμκ³ , 27λͺ
μ ννμ(27/78, 35%)κ° μ΅μ μ ννμμ ν΄λΉνμλ€. HLA μ ν©ννμλ₯Ό μ°Ύμ μ μμλ νμ μ€ 8λͺ
μκ² 19λͺ
μ ννμλ‘λΆν° μ΄ 32νμ νμν μ±λΆμ±μ§μ μννμ¬ μννμλ€. μ΅μ μ ννμκ΅°μμλ μμνν νμν
μνμ λΉν΄ μν ν 1μκ° λ° 24μκ° CCI κ° μ μνκ² μ¦κ°νμμΌλ(17,893 vs 2,358, P =0.003; 8,292 vs -614, P<0.001), μ°¨μ μ ννμκ΅°μμλ μ΄λ¬ν μ°¨μ΄κ° κ΄μ°°λμ§ μμλ€. νμν 보κ΄μκ°κ³Ό CCI κ°μ μμκ΄κ΄κ³λ₯Ό λ³΄μ¬ μ±μ§ ν 10μκ° μ΄λ΄μ νμνμ μν μ 1μκ° λ° 24μκ° CCIκ° μ μνκ² λμ κ°μ 보μλ€. ABO μΌμΉ μ¬λΆμ νμμ ννμμ νμ°/λΉνμ° κ΄κ³ μ¬λΆλ νμν μνν¨κ³Όμ λ³λ€λ₯Έ μν₯μ 보μ΄μ§ μμλ€.
κ²°λ‘ : HLA λμ’
λ©΄μμ μν νμνλΆμμ¦ νμμμ HLA κ΅μ°¨μν μ ν© ννμλ‘λΆν° μν μ ν¨κ³Όμ μΈ νμν μμ μ¦κ°λ₯Ό 보μλ€. μ΄ λ°©λ²μ HLA μ ν© νμν ννμ λ±λ‘μ λκ° μ립λμ΄ μμ§ μμ κ²½μ°μ ν¨κ³Όμ μΌλ‘ μ΄μ©λ μ μλ€.Hod E, 2008, BRIT J HAEMATOL, V142, P348, DOI 10.1111/j.1365-2141.2008.07189.xPetz LD, 2000, TRANSFUSION, V40, P1446Kiefel V, 2001, TRANSFUSION, V41, P766WU KK, 1977, TRANSFUSION, V17, P638HERZIG RH, 1977, TRANSFUSION, V17, P657KLINGEMANN HG, 1987, BRIT J HAEMATOL, V66, P115HEAL JM, 1987, BLOOD, V70, P23BOLGIANO DC, 1989, TRANSFUSION, V29, P306MOROFF G, 1992, TRANSFUSION, V32, P6331997, N ENGL J MED, V337, P1861Legler TJ, 1997, ANN HEMATOL, V74, P185Sacher RA, 2003, ARCH PATHOL LAB MED, V127, P409MCFARLAND JG, 2003, APHERESIS PRINCIPLES, P199Datema G, 2000, VOX SANG, V79, P108PARK MH, 1999, KOREAN J BLOOD TRANS, V10, P203Davis KB, 1999, TRANSFUSION, V39, P586PARK HD, 2004, KOREAN J LAB MED, V24, P426Vassallo RR, 2007, CURR OPIN HEMATOL, V14, P655
IgG κ°μ λμ νꡬλ₯Ό μ΄μ©ν νμν νμ, ν체 κ²μ¬μ© νΌν©μλμ νꡬμμ§λ²μ κ°λ°
νμλ
Όλ¬Έ(μμ¬) --μμΈλνκ΅ λνμ :μνκ³Ό(κ²μ¬μνμ 곡),2008. 8.Maste