HLA-Matched Platelets Supply in Korea: Current Status and Future Challenges

Background: Human leukocyte antigen-matched platelets (HLA-matched PLTs) are essential for treating immune-mediated platelet transfusion refractoriness (PTR), but maintaining a stable supply is challenging because of the limited availability of HLA-matched donors.This study analyzed the HLA-matched PLTs supply by the Korean Red Cross Blood Services (KRCBS) and compared it with overseas blood services to identify strategies for improving the supply system.Methods: HLA-matched PLTs supply data recorded in the Blood Information Management System (BIMS) from 2018 to 2025 were analyzed retrospectively.Annual requests, supplies, HLA matching grades, and the proportion of highly compatible grades (A, B1U, and B2U) were evaluated.Data from Asia Pacific Blood Network (APBN) member organizations were used to compare the HLA donor registry management, irradiation practices, and reimbursement systems.Results: Between 2018 and 2025, the KRCBS supplied 3,658 units of HLA-matched PLTs, with an annual supply generally increasing despite fluctuations.B2X-grade platelets accounted for 69.1% of all supplied units, whereas grades A, B1U, and B2U accounted for only 4.2%.Among the four APBN organizations, three routinely irradiated HLA-matched PLTs before release, whereas one provided irradiated units upon hospital request.Two organizations applied differentiated pricing according to the platelet product type.Conclusion: Stable HLA-matched PLTs supply in Korea requires an expansion of the HLA-matched donor registry and the efficient use of the national hematopoietic stem cell donor registry.Standardized quality management, including pre-release irradiation, appropriate reimbursement, and indication-based requests with post-transfusion monitoring, should be considered to improve the efficiency and sustainability of this limited blood resource.(Korean J Blood Transfus 2026;37:65-75)