Use of in vitro assays in selection of compatible platelet donors

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Abstract
Although HLA-matched platelet transfusions are of value in the support of some alloimmunized thrombocytopenic patients, poor posttransfusion increments can be observed following HLA-matched platelet transfusion and conversely good posttransfusion increments may result after HLA-mismatched platelet transfusions. The possibility was explored that in vitro assays in addition to HLA typing might better select compatible donors for refractory recipients. A platelet migration inhibition assay is apparently predictive of platelet transfusion responses in HLA-compatible and incompatible donor-recipeint pairs, while lymphocytotoxicity is predictive of posttransfusion increments only in HLA-incompatible donor-recipient pairs. Granulocytotoxicity, microleukoagglutination and capillary leukoagglutination showed no value in predicting platelet transfusion increments, in HLA-compatible or incompatible donor-recipient pairs.