Analysis of the possibility of selecting platelet donors for patients with refractoriness

The development of immune refractoriness to platelet concentrate transfusions is associated with the presence of alloantibodies to the antigens of the ABO, Levis, I, i, P, HLA (Human Leukocyte Antigen) class I systems represented on the platelet membrane of the donor and, directly, to platelet-specific antigens HPA (Human Platelet Antigens). The main reason for the lack of platelet growth in the blood and reduction of hemostatic effect in patients with multiple transfusions is the presence of HLA-A and/or HLA-B antibodies, however, in refractory patients, HPA antibodies are also found. Currently, the selection of donor platelets is carried out according to the ABO and Rh-affiliation system, the antigenic composition of the platelets of the donor and recipient is not taken into account. The probability of compatibility of a donor/recipient pair selected without taking into account the antigenic composition of platelets is low, since the frequency of alleles of most genes of the HPA system deviates towards the "a" allele, and homozygotes for "b" range from 0 to 15%. The possibility of selecting a donor/recipient pair taking into account the genotype will allow to achieve a therapeutic effect in transfusions of donor platelets and increase the effectiveness of therapy in patients with rare allelic variants of the HPA gene.