| ObjectiveHLAMatchmaker is used to analyze HLA genotypes of patients receiving long-term platelet transfusions, HLA antibodies in their serum, and HLA genotypes of the donors. The objective of this study is to investigate the distribution of HLA antibodies in patients after multiple platelet transfusions and to investigate the relationship between the outcome of platelet transfusions, HLA antibodies in patients’ serum, and the degree to which the patient matches the donor at structural epitope (eplet) level.MethodsA group of 42 children and 7 adult patients with hematologic diseases and long-term platelet transfusions were enrolled in this study.24h CCI<10 was suggested platelet refractoriness. PCR-SBT was used to determine the HLA-A and HLA-B types of the patients and donors. Single antigen beads were used to identify the specificities of HLA antibodies in the patients’ serum. The recipient’s four-digit HLA allelic types were entered into the program. The resulting data of the HLA specific antibodies represented by the single-antigen beads were then entered into the program for determining the antibodies specificity at eplet level. For the patients with donors, eplet based matching was also done with HLAMatchmaker.ResultsA total of 11 platelet transfusions for children and 7 platelet transfusions for adult were refractory. The specificities of HLA antibodies analysis results showed that 31 of 49 patients’ serum were antibody positive (63.27%).24 of 42 children patients’ serum were antibody positive (57.14%), while 7 of 7 adult patients’ serum were antibody positive(100%). At the allele level,91 antibody specificities including 31 HLA-A specificities,45 HLA-B specificities and 15 HLA-C specificities were detected in 24 positive children patient’s serum. The most frequent specificities for HLA-A, B, C were A*68:02, B*15:12, C* 17:01, respectively. All the 97 antibody specificities including 31 HLA-A specificities,50 HLA-B specificities and 16 HLA-C specificities were detected in 7 positive adult patients’ serum. The most frequent specificities for HLA-A, B, C were A*24:03, A*68:02, B*15:12, B*57:03, C*15:02, C*02:02, respectively. Because 1 of 24 antibody positive patients could not be analyzed by HLAMatchmaker, the analysis of antibodies specificities at eplet level enrolled 30 patients. The most frequent eplet were 12SMR,163LG,245VA,267PE,35Q (≥14) in the 23 patients’ serum.12SMR,80EGT,152RW,17RS,56R (≥7) were the most frequent eplet in the serum of 13 children patients whose platelet transfusion were effective.12SMR, 163LG,35Q,267PE (>6) were the most frequent eplet in the serum of 10 children patients with platelet refractoriness.12SMR,163LG,71KA,103M,177DK,245VA,267QE,270C,275KP (≥5) were the most frequent eplet in 7 adult patients’ serum.ConclusionsThe specificities of HLA antibodies in the serum of patients with long-term platelet transfusions exhibit certain characteristics:The most frequent specificities for HLA-A, B were A*68:02 and B*15:12, respectively. The most frequent eplet were 12SMR,163LG,245VA,267PE,35Q. The analysis of antibodies specificities in patient serum and the compatibility between patients and their donors at eplet level illustrated that 12SMR,163LG,9H and 71NT might be clinical important. All the results may need to be confirmed a larger set of samples.Objective To ivestigate the allele distributio of HPA-I —6,15 in Titetan blood donors from Lhasa.Methods The genotyping of HPA-1 —6,15 were performed bye PC with seque ce-speci c primers(PCR-SSP). AU)tal of 405 heay volunteer unrelated Tibetan blood donors were included. All primers were tested for their specificities with the reference DNA of 14 Platelet Immunology Workshop of International Society of lood Transsion(ISBT,2008). Some samples were also validated by comparing wiesults from genotyping by ensure accuracy of typing results.Results The genotyping results of 15 reference DNA sampl from 14 Platelet Immunology Workshop of the International Society of Blood Transfiision qSBT,200 were in accordance widi the reference results. The allele frequencies of HPA-1 a/-2a/2b,-3a/3b,-4a/4b,-5a/5b,-6a/6b and-15a/l 5b were 0.9383/0.0617;0.9716/0.0284;0.6173/(U827;0.9926/0.0074;0.9494/0.0506;0.9914/0.0086; 0.6037/0.3963, respectively. No HPA-2b, HPA-4b or HPA-6b homozygote had been found in Tibetan. There was no significant deviation from the Hardy-Weinberg equilibrium in ay systems stued in Tibe0.05). The aUele frequencies ofe Tibetan for HPA-1,HPA-2,HPA-5 and HPA-15 systems were significantly different from North Chine Han populations=904). When compared Tibetan with South Chinese Han(n=I554), the allele freque cies of HPA-1, HPA-2, HPA-3, HPA-4, HPA-5 and HPA-15 were all significantly different.The allele frequency of HPA-2 were significantly different between the Tibetan and Xinjiang Khalkhas(n=105), such a markedly difference was only found in HPA-2 system. The distributions of HPA-1, HPA-2, HPA-3 and HPA-5 systems were sign巧cantly different between Tibetan and Korea (n=200) in which the frequency of HPA-] 5 was ot tested. While signifies t difference between Tibetan and Congolese(=125), HPA-2, HPA-5 and HPA-15 system were involved. In addition, significa t difference wiegard the distributions of HPA-1, HPA-2 a d HPA-15 systems could be observed between Tibetan and Caucasian in Geraiany(n=119).Conclusion The HPA-lb allele frequency ine Tibetan blood donors from Lhasa was lower anat found in Caucasian from Germany but significantly higher ane other compared Mongolian race except for Xinjiang Khalkhas. Thus, the appearance of HPA-lbb homozygo suggested that Tibetan individuals ra an incase risk of a ti-platelloimmunity. Our study demostates stribution of HPA-1—6,15 in Tibe blood do ors from Lhasa exhibit unique characteristics. |
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