中国输血杂志2025，Vol.38Issue(3)：316-321,6.DOI:10.13303/j.cjbt.issn.1004-549x.2025.03.003
HLA抗原抗体表达对交叉配型与输注效果的影响
Impact of HLA antigen and antibody expression on cross-matching and transfusion effect
摘要
Abstract
Objective To study the relationship between the expression intensity of HLA-Ⅰ platelet antibodies in pa-tients with platelet transfusion refractoriness(PTR)and platelet cross-matching,and to further evaluate other factors in or-der to provide relevant data support for improving platelet transfusion efficiency and optimizing platelet transfusion regimens.Methods Luminex single antigen flow cytometry was used to detect platelet specific antibodies in 35 patients with hemato-logical disease.Subsequently,the Capture-P method was employed to perform 102 crossmatchings between plasma with HLA-Ⅰ antibodies and platelets with known HLA-Ⅰ genotypes.The cross-matching results were assessed and the clinical transfusion outcomes were tracked.Results The positive detection rate of HLA-Ⅰ and HPA antibodies in this study was 48.6%(17/35).The negative rate of cross-matching in 102 cases was 37.3%(38/102).Multiple factors affect platelet cross-matching,such as HLA-Ⅰ antibody expression level and antibody type,antigen expression level,cross-reactivity group and eplets.Among them,the expression level and antibody type of HLA-Ⅰ antibody are the main influencing factors.However,the effectiveness of clinical platelet transfusion is not completely determined by the compatibility of platelet cross-matching.Conclusion In addition to avoiding strong positive HLA-Ⅰ antibodies,clinical matching should also be vigilant against the serological cross-incompatibility caused by weak positive HLA-Ⅰ antibodies.It may be necessary to establish HLA-Ⅰ low expression antigen database as a better alternative platelet donor selection strategy,and gradually explore the effectiveness of'low expression mismatch'strategy for clinical platelet transfusion.关键词
HLA-Ⅰ类抗体/血小板交叉配型/Eplet/HLA-Ⅰ类低表达抗原Key words
HLA-Ⅰ antibodies/platelet cross-matching/eplet/HLA-Ⅰ low-expression antigen分类
医药卫生引用本文复制引用
何红红,成婧,王仪含,蒋敏,汤龙海..HLA抗原抗体表达对交叉配型与输注效果的影响[J].中国输血杂志,2025,38(3):316-321,6.基金项目
苏州市卫生青年骨干人才"全国导师制"培训项目(Qngg2022033) （Qngg2022033）
苏州市姑苏卫生人才计划(GSWS2022096 （）
2022-160) （）
苏州市卫生科技项目(SKY2023077) （SKY2023077）
苏州市公卫专项项目(GWZX202303) （GWZX202303）
