Establishing an HLA-Typed Plateletpheresis Donor Registry at the Iranian Blood Transfusion Organization
Abstract
Administering human leukocyte antigen (HLA)-compatible platelets is a tactic for treating patients with poor responses to random platelet injections. HLA-matched platelet provision requires many donors with HLA-typed and organized information. This study, the first of its kind in Iran, aimed to develop a registry system of HLA-typed platelet donors to facilitate the provision of compatible platelets to patients, leveraging the diversity of HLA alleles across Iran's various provinces.
This study involved the HLA-typing of 1850 plateletpheresis donors, who were also registered as unrelated stem cell donors, across all blood centers in Iran from 2015 to 2022. HLA-A and HLA-B genotyping was conducted at a low-resolution using polymerase chain reaction-sequence specific primers (PCR-SSP) and real-time PCR. Statistical analysis was performed to determine allelic genotypes and donor profiles.
The majority of the donors were male (99.7%), with a mean age of 36 years. The high donor rate in Tehran indicates a larger pool of potential HLA-platelet donors due to a denser population and more donation facilities. The donors were recruited for HLA-compatible plateletpheresis. The frequency of HLA-AB alleles among donors was relatively consistent with those documented by Iranians.
Our findings can be utilized to create a foundational HLA database. A registry system for HLA-typed platelet donors is crucial due to high HLA polymorphism and ethnic diversity. This system facilitates the rapid identification of compatible donors based on HLA typing. Additional inquiries are needed to expand the plateletpheresis registry and make a request-supply mechanism between the Iranian Blood Transfusion Organization and hospitals.
2. Rajadhyaksha SB, Desai PD, Navkudkar AA. Platelet refractoriness. Global J Trans Med. 2019;4(2):140-7.
3. Forest SK, Hod EA. Management of the platelet refractory patient. Hematol Oncol Clin. 2016;30(3):665-77.
4. Sacher RA, Kickler TS, Schiffer CA, Sherman LA, Bracey AW, Shulman IA. Management of patients refractory to platelet transfusion. Arch Pathol Lab Med. 2003;127(4):409-14.
5. Sharma R, Marwaha N. Leukoreduced blood components: Advantages and strategies for its implementation in developing countries. Asian J Trans Sci. 2010;4(1):3-8.
6. Schmidt AE, Refaai MA, Coppage M. HLA-mediated platelet refractoriness: an ACLPS critical review. Am J Clin Pathol. 2019;151(4):353-63.
7. Couvidou A, Rojas-Jiménez G, Dupuis A, Maître B. Anti-HLA Class I alloantibodies in platelet transfusion refractoriness: From mechanisms and determinants to therapeutic prospects. Frontiers in Immunology. 2023;14:1125367.
8. Cosgrove LJ, Vaughan HA, Tjandra JJ, Thurlow PJ, McKenzie IF. HLA (class I) antigens on platelets are involved in platelet function. Immunol Cell Biol. 1988;66(1):69-77.
9. Novotny V. Prevention and management of platelet transfusion refractoriness. Vox Sanguinis. 1999;76(1):1-13.
10. Dargahi T, Yari F, Rezaei N. The source of HLA molecules on platelets: Does platelets adsorb soluble HLA molecules from their environment? Iran J Ped Hematol Oncol. 2019.
11. Cohn CS. Platelet transfusion refractoriness: how do I diagnose and manage? Hematology 2014, the American Society of Hematology Education Program Book. 2020;2020(1):527-32.
12. Seike K, Fujii N, Asano N, Ohkuma S, Hirata Y, Fujii K, et al. Efficacy of HLA virtual cross‐matched platelet transfusions for platelet transfusion refractoriness in hematopoietic stem cell transplantation. Transfusion. 2020;60(3):473-8.
13. Yuan S. Platelet transfusion: Indications, ordering, and associated risks. UpToDate, Waltham. 2021.
14. Kwon S-Y, Lee SA, Lim A-H, Cho N-S, Jung CH, Yang JH, Park KU. Korean red cross HLA-matched platelet donor registry. Korean J Blood Transfusion. 2015;26(3):291-9.
15. Karlström C, Linjama T, Edgren G, Lauronen J, Wikman A, Höglund P. HLA‐selected platelets for platelet refractory patients with HLA antibodies: a single‐center experience. Transfusion. 2019;59(3):945-52.
16. Tosato G, Applebaum FR, Deisseroth AB. HLA-matched platelet transfusion therapy of severe aplastic anemia. Blood. 1978;52(4):846-54.
17. Shaiegan M, Abolghasemi H, Yari F, Paridar M, Maghsudlu M, Amini Kafiabad S, et al. Comparison of Human Leukocyte Antigen Frequency in Iranian unrelated Stem cell donors during 2011-2012. Sci J Iranian Blood Transfusion Organization. 2013;10(3).
18. Stanworth SJ, Navarrete C, Estcourt L, Marsh J. Platelet refractoriness–practical approaches and ongoing dilemmas in patient management. British J Haematol. 2015;171(3):297-305.
19. Adane T, Enawgaw B. Human leukocyte antigen alloimmunization prevention mechanisms in blood transfusion. Asian J Transfusion Sci. 2023.
20. Xia W, Ye X, Tian L, Xu X, Chen Y, Luo G, et al. Establishment of platelet donor registry improves the treatment of platelet transfusion refractoriness in Guangzhou region of China. Transfusion Med. 2010;20(4):269-74.
21. Ayed K, Jendoubi SA, Makhlouf M, Sfar I, Abdallah TB. Comparison of HLA Class I and II molecular and serological typing within clinical laboratory. Saudi J Kidney Dis Transpl
. 2003;14(1):39-42.
22. Dutra VdF, Bub CB, Costa TH, Santos LD, Bastos EP, Aravechia MG, Kutner JM. Allele and haplotype frequencies of human platelet and leukocyte antigens in platelet donors. Einstein (Sao Paulo). 2019;17:eAO4477.
23. Ghafouri-Fard S, Hussen BM, Pashmforoush S, Akbari MT, Arsang-Jang S, Nazer N, et al. HLA alleles and haplotype frequencies in Iranian population. Human Antibodies. 2022;30(2):79-96.
24. Otten H, Tilanus M, Barnstijn M, Van Heugten J, De Gast G. Serology versus PCR‐SSP in typing for HLA‐DR and HLA‐DQ: a practical evaluation. Tissue Antigens. 1995;45(1):36-40.
25. Kim Y, Lim AH, Kim TE, Jung CH, Park M, Seon J, et al. Current status of Korean Red Cross HLA-matched platelet donor registry. Korean J Blood Transfusion. 2021;32(1):1-10.
26. Kreuger AL, Haasnoot GW, Somers JA, Tomson B, van der Bon JG, van Kraaij MG, Weller CM. Ensuring HLA‐matched platelet support requires an ethnic diverse donor population. Transfusion. 2020;60(5):940-6.
27. Xu D, Sun C, Yu L, He Y, Deng G, Zhang J. Methodological Study on the Establishment of HLA/HPA Gene Bank of Platelet Donors and Its Clinical Application. Indian J Hematol Blood Transfusion. 2023;39(1):123-31.
28. Bolgiano D, Larson E, Slichter S. A model to determine required pool size for HLA‐typed community donor apheresis programs. Transfusion. 1989;29(4):306-10.
29. Petz LD, Garratty G, Calhoun L, Clark BD, Terasaki PI, Gresens C, et al. Selecting donors of platelets for refractory patientson the basis of HLA antibody specificity. Transfusion. 2000;40(12):1446-56.
30. Gammon RR, Coberly E, Dubey R, Jindal A, Nalezinski S, Varisco JL. Patient blood management—It is about transfusing blood appropriately. Ann Blood. 2022;7.
31. Schiffer C. Diagnosis and management of refractoriness to platelet transfusion. Blood Rev. 2001;15(4):175-80.
32. Leen G, Stein JE, Robinson J, Maldonado Torres H, Marsh SG. The HLA diversity of the Anthony Nolan register. Hla. 2021;97(1):15-29.
33. Takahashi K, Juji T, Miyazaki H. Determination of an appropriate size of unrelated donor pool to be registered for HLA‐matched platelet transfusion. Transfusion. 1987;27(5):394-8.
Files | ||
Issue | Articles in Press | |
Section | Original Article(s) | |
Keywords | ||
HLA-A antigens HLA-B antigens Donors Platelet transfusion |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |