HLA antibodies can lead to patients becoming refractory to platelet transfusions, and transfusions can be difficult when HLA-matched donors cannot be found. Only a few case reports have examined denaturing HLA Class I antigens from platelets before transfusion, and the transfusion outcomes have been variable. Results from a new study published in TRANSFUSION suggest that acid treatment removes 70-90% of the Class I HLA complexes. These platelets remain viable, aggregate normally, respond normally to natural agonists, and protect platelets from HLA-antibody-mediated complement lysis and monocyte-mediated phagocytosis in vitro. The results suggest that acid-treated platelets may be an alternative to HLA-matched platelets in refractory patients. The immunogenicity and refractoriness of acid-treated platelets, however, requires further study.
- Meinke S, Sandgren P, Mortberg A, Karlstrom C, Kadri N, Wikman A, Hoglund P. Platelets made HLA deficient by acid treatment aggregate normally and escape destruction by complement and phagocytes in the presence of HLA antibodies. Transfusion 2016;56: 370-82.
Transfusion offers CME credit for this study! Log on at www.wileyhealthlearning.com/trf.