基于血小板HLA基因库配型治疗血小板输注难治性的临床实践

细胞与分子免疫学杂志 Pub Date : 2025-07-01
Yan Liu, Lili Liu, Jingru Shao, Xiangmin Nie, Peicong Zhai
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引用次数: 0

摘要

目的探讨HLA-基因型匹配血小板输注对HLA抗原抗体不相容所致严重血小板输注难治性(PTR)的治疗效果。方法采用实时定量PCR (real-time quantitative PCR, qPCR)技术鉴定患者HLA I类基因型,在血小板供体数据库中搜索匹配供体,选择高度匹配的供体输血。输血建议优先考虑相容性较高的血小板。结果19例患者中,7例患者找到B2U及以上配型的供体,6例患者找到BX及以上配型的供体,6例患者未找到合适的供体。通过计算输血后24小时的校正计数增量(CCI)来评价输血效果,所有输血均有效。结论预防和治疗严重血小板输注难治性患者的最佳策略是确保输注与患者HLA基因匹配的血小板,可显著提高输注疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Clinical practice of treating platelet transfusion refractoriness based on platelet HLA gene bank matching].

Objective To investigate the therapeutic efficacy of HLA-genotype matched platelet transfusion using a platelet donor database for severe platelet transfusion refractoriness (PTR) caused by HLA antigen-antibody incompatibility. Methods Using real-time quantitative PCR (qPCR) to identify he patient's HLA class I genotype, followed by searching the platelet donor database for matching donors, and selecting highly compatible donors for transfusion. Platelets with higher compatibility levels were prioritized for transfusion recommendations. Results Among the 19 patients studied, 7 patients identified donors with B2U or higher compatibility, 6 patients identified donors with BX or higher compatibility, and 6 patients did not find a suitable donor. The transfusion efficacy was evaluated by calculating the corrected count increment (CCI) 24 hours post-transfusion, and all transfusions were effective. Conclusion The optimal strategy to prevent and treat patients with severe platelet transfusion refractoriness is to ensure patients receive platelet transfusions that are matched to their HLA genes, and this approach significantly enhances transfusion efficacy.

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