血站单采血小板献血者HLA和HPA基因型数据库的调查和分析
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摘要
目的调查分析国内血站系统单采血小板献血者HLA和HPA基因型数据库情况,以促进其建库发展和应用。方法制定调查表并经专业人员审定,培训调查人员后依据实际情况填写表单,然后收集数据进行分析。结果调查的24个血站中,有18个建立了血小板献血者HLA和HPA基因型数据库,合计有25 240人;2017年HLA或HPA基因型配合应用总共为137例。有5个血站建立了CD36抗原阴性筛查数据库。入库标本进行了HLA-A,-B位点检测,而HPA系统检测范围不同血站存在差异,其中9个血站只检测HPA 1-6, 15, 21w系统。13个血站采用聚合酶链反应核苷酸特异性引物技术检测HPA系统基因型。13个血站开展HPA抗体检测,6个血站开展CD36抗体检测。结论血站已建立一定规模的单采血小板献血者HLA和HPA基因型数据库,但其应用存在明显不足。
Objective To investigate the HLA and HPA genotype database for platelet apheresis donors in domestic blood services to promote its development and application. Methods A questionnaire was designed and audited by the experts. The questionnaire was filled by trained staff, then the data was collected and analyzed. Results The HLA and HPA genotype database for platelet apheresis donors were established in 18 blood services among the 24 blood services investigated in this study. The total donors in the database were 25 240, and 137 donations(including HLA or HPA matching) were applied in 2017. Five blood services have established CD36 antigen negative blood donor database. All donors in the HLA and HPA genotype database have genotyped for HLA-A,-B loci. However, the numbers of HPA systems genotyped were various in the different blood services, and only HPA 1-6, 15 and 21 w systems were genotyped in 9 blood services. Polymerase chain reaction sequence specific primer were used to genotype HPA systems in 13 blood services. In additional, anti-HPA test was conducted in 13 blood services and anti-CD36 test was performed in 6 blood services. Conclusion The HLA and HPA genotype database for platelet apheresis donors were established with certain scale in partial blood services, but there was obvious deficiency in their application.
Objective To investigate the HLA and HPA genotype database for platelet apheresis donors in domestic blood services to promote its development and application. Methods A questionnaire was designed and audited by the experts. The questionnaire was filled by trained staff, then the data was collected and analyzed. Results The HLA and HPA genotype database for platelet apheresis donors were established in 18 blood services among the 24 blood services investigated in this study. The total donors in the database were 25 240, and 137 donations(including HLA or HPA matching) were applied in 2017. Five blood services have established CD36 antigen negative blood donor database. All donors in the HLA and HPA genotype database have genotyped for HLA-A,-B loci. However, the numbers of HPA systems genotyped were various in the different blood services, and only HPA 1-6, 15 and 21 w systems were genotyped in 9 blood services. Polymerase chain reaction sequence specific primer were used to genotype HPA systems in 13 blood services. In additional, anti-HPA test was conducted in 13 blood services and anti-CD36 test was performed in 6 blood services. Conclusion The HLA and HPA genotype database for platelet apheresis donors were established with certain scale in partial blood services, but there was obvious deficiency in their application.
引文
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[13] Xia W,Ye X,Xu X,et al.Two cases of platelet transfusion refractoriness and one case of possible FNAIT caused by antibodies against CD36 in China.Transfus Med,2014,24(4):254-256.
[14] Sullivan MJ,Peterson J,McFarland JG,et al.A new low-frequency alloantigen (Kha(b) ) located on platelet glycoprotein IIIa as a cause of maternal sensitization leading to neonatal alloimmune thrombocytopenia.Transfusion,2015,55(6 Pt 2):1584-1585.
[15] Hong X,Chen S,Ying Y,et al.Simultaneous genotyping of human platelet alloantigen-1 to 28bw systems by multiplex polymerase chain reaction sequence-based typing.Vox Sang,2017,112(4):360-366.
[2] Pavenski K,Freedman J,Semple JW.HLA alloimmunization against platelet transfusions:pathophysiology,significance,prevention and management.Tissue Antigens,2012,79(4):237-245.
[3] Juskewitch JE,Norgan AP,De Goey SR,et al.How do I manage the platelet transfusion-refractory patient?Transfusion,2017,57(12):2828-2835.
[4] Forest SK,Hod EA.Management of the platelet refractory patient.Hematol Oncol Clin North Am,2016,30(3):665-677.
[5] Kopko PM,Warner P,Kresie L,et al.Methods for the selection of platelet products for alloimmune-refractory patients.Transfusion,2015,55(2):235-244.
[6] Bub CB,Torres MA,Moraes ME,et al.Determination of an unrelated donor pool size for human leukocyte antigen-matched platelets in Brazil.Rev Bras Hematol Hemoter,2016,38(1):1-6.
[7] 焦淑贤,迟小云,冯智慧,等.青岛地区已知HLA和HPA分型血小板供者库的建立及临床应用.中国输血杂志,2010,23(9):675-678.
[8] Peňa JR,Saidman SL,Girouard TC,et al.Anti-HLA alloantibodies in surgical patients refractory to platelet transfusion.Am J Hematol,2014,89(9):E133-137.
[9] Solves P,Sanz J,Freiria C,et al.F actors influencing platelet transfusion refractoriness in patients undergoing allogeneic hematopoietic stem cell transplantation.Ann Hematol,2018,97(1):161-167.
[10] Moncharmont P.Platelet component transfusion and alloimmunization:Where do we stand?Transfus Clin Biol,2018,25(3):172-178.
[11] Brouk H,Bertrand G,Zitouni S,et al.HPA antibodies in Algerian multitransfused patients:prevalence and involvement in platelet refractoriness.Transfus Apher Sci,2015,52(3):295-299.
[12] Wang J,Xia W,Deng J,et al.Analysis of platelet-reactive alloantibodies and evaluation of cross-match-compatible platelets for the management of patients with transfusion refractoriness.Transfus Med,2018,28(1):40-46.
[13] Xia W,Ye X,Xu X,et al.Two cases of platelet transfusion refractoriness and one case of possible FNAIT caused by antibodies against CD36 in China.Transfus Med,2014,24(4):254-256.
[14] Sullivan MJ,Peterson J,McFarland JG,et al.A new low-frequency alloantigen (Kha(b) ) located on platelet glycoprotein IIIa as a cause of maternal sensitization leading to neonatal alloimmune thrombocytopenia.Transfusion,2015,55(6 Pt 2):1584-1585.
[15] Hong X,Chen S,Ying Y,et al.Simultaneous genotyping of human platelet alloantigen-1 to 28bw systems by multiplex polymerase chain reaction sequence-based typing.Vox Sang,2017,112(4):360-366.