Analysis of HLA-I Antibody Distribution and Corresponding Transfusion Effectiveness in Patients with Platelet Transfusion Refractoriness

To investigate the differences in HLA-I antibody distribution and corresponding platelet transfusion effectiveness among patients with a history of platelet transfusion refractoriness(PTR) in the Han population of Zhejiang, China, to ensure the rational utilization of platelet resources.A retrospective analysis was conducted on 77 patients with a history of PTR admitted to the Hematology Department of Zhejiang Provincial Hospital of Traditional Chinese Medicine from May 2018 to December 2022. Testing was conducted for HLA-I antibodies in platelets were tested using an immune microsphere liquid chip. The distribution of antibodies and their intensities were analyzed along with the distribution characteristics of antibodies by disease type, sex, age, and blood type. Furthermore, the relationships between HLA-I antibody intensity distribution and transfusion frequency, as well as transfusion outcomes, were explored.The average positive rates of HLA-A, -B, and -C antibodies were 0.393, 0.527, and 0.242. The number of weakly positive and total positive HLA-I antibodies in the ITP group was significantly lower than in the other disease categories (<i>P</i> < 0.05).Positive HLA-I antibody count was not related to the patient's sex, blood type, or age. In contrast, positive HLA-I antibody count was significantly higher for platelet transfusions > 10 than for platelet transfusions ≤ 10. As anticipated, the effectiveness of HLA standard antigen-matched platelet transfusions was significantly superior to random platelet transfusions (<i>P</i> < 0.001).The distribution of HLA-I antibodies in PTR patients among the Han Chinese population in Zhejiang, China is relatively extensive. An increase in the frequency of platelet transfusions leads to higher frequency and stronger intensity of HLA-I antibody production, resulting in poorer transfusion outcomes. HLA standard antigen-matched platelet transfusions can effectively address the occurrence of PTR.