中国输血杂志2024，Vol.37Issue(6)：673-677,5.DOI:10.13303/j.cjbt.issn.1004-549x.2024.06.011
HLA-A、-B功能表位错配对血液病患者血小板输注效果的影响分析
Effect of HLA-A,-B functional epitope mismatch on platelet transfusions in patients with hematological diseases
俞露 1贺云蕾 1何意文 2李双月 3陈春销 3邓刚1
作者信息
- 1. 宁波市中心血站 输血研究所,浙江 宁波 315000
- 2. 宁波大学附属第一医院 输血科
- 3. 宁波大学医学院附属人民医院 血液科
- 折叠
摘要
Abstract
Objective To investigate the impact of human leukocyte antigen(HLA)functional epitope mismatch(EM)on the efficacy of platelet transfusion in patients with hematological diseases.Methods HLA genotyping was performed on platelet donors and patients with hematological diseases who applied for platelet serological cross-matching and HLA antigen matching from June 2021 to June 2023 by PCR-SBT method.HLA platelet matching was based on the principle of CREG to se-lect donors for patients.HLA Matchmaker 4.0 software was used to analyze donor-recipient HLA EM information.The expres-sion level and gene distribution of related HLA functional epitope(Eplet)were searched from the international HLA Epitope registry website(www.Epregistry.com.br).Retrospective analysis was conducted on clinical platelet transfusion data to evalu-ate the impact of HLA EM on platelet transfusion effectiveness.Results Platelet transfusion efficacy showed no correlation with gender and age,but it was associated with platelet matching strategy.When the total number of HLA EMs was less than 20,a lower total number of donor-recipient HLA EMs resulted in higher platelet transfusion efficiency(χ2=19.311,P=0.001)and higher average value of 24 h corrected count increment(CCI)(F=7.737,P<0.001).The total number of donor-recipient HLA EMs had negative correlation with actual 24 h CCI(Rho=-0.322,P<0.001).Further statistical analysis re-vealed that 17 Eplets were related to the effectiveness of platelet transfusion.The locus distribution of 17 Eplets might be u-nique to HLA-A(17.6%)or-B(64.7%)or shared between HLA-A and-B(17.6%),and its expression may be high(58.8%)or intermediate(41.2%).Conclusion The total number of donor-recipient HLA EMs is a crucial factor influencing platelet transfusion effectiveness,and several HLA Eplets associated with this effectiveness have been identified.关键词
血小板输注无效/抗原表位错配/HLA/表位Key words
platelet transfusion refractoriness/epitope mismatch/HLA/epitopes分类
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俞露,贺云蕾,何意文,李双月,陈春销,邓刚..HLA-A、-B功能表位错配对血液病患者血小板输注效果的影响分析[J].中国输血杂志,2024,37(6):673-677,5.
