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2362 Part XIII: Transfusion Medicine Chapter 137: Human Leukocyte and Platelet Antigens 2363

thrombocytopenic purpura. Phase III assays have an advantage over 5. Holdsworth R, Hurley CK, Marsh SG, et al: The HLA dictionary 2008: A summary of
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both phase I and phase II tests in that they detect antibodies that bind HLA-A, -B, -C, DRB1/3/4/5, and DQB1 alleles and their association with serologically
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bilization of platelet antigens assay (MAIPA) and the modified anti- 7. Thorsby E: Structure and function of HLA molecules. Transplant Proc 19:29, 1987.
gen capture ELISA (MACE). 143 8. Le Bouteiller P: HLA class I chromosomal region, genes, and products: Facts and ques-
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Although most of the platelet antibody detection methods can be 9. Mueller-Eckhardt G, Hauck M, Kayser W, Mueller-Eckhardt C: HLA-C antigens on
employed to determine platelet alloantigen types of individuals, because platelets. Tissue Antigens 16:91, 1980.
of limited access to rare typing sera and the need to establish platelet 10. Bjorkman PJ, Saper MA, Samraoui B, et al: The foreign antigen binding site and T cell
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typing in patients with very few platelets, they have been largely sup- 11. Campbell RD, Trowsdale J: Map of the human MHC. Immunol Today 14:349, 1993.
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elucidated at the gene level. 144–150 14. Yewdell JW, Bennink JR: The binary logic of antigen processing and presentation to T
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FNAIT; patients who develop dramatic thrombocytopenia after blood ture for factors of the HLA system, update April 2010. Tissue Antigens 76: 501, 2010.
transfusion (PTP); and patients who have received multiple transfu- 18. Cao K, Hollenbach J, Shi X, et al: Analysis of the frequencies of HLA-A, B, and C alleles
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Chap. 139), occasionally patients receiving multiple platelet transfusions United States population. Hum Immunol 68:779, 2007.
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platelet transfusions. Fortunately, these cases are extremely rare. 152,154 26. Flomenberg N, Baxter-Lowe LA, Confer D, et al: Impact of HLA class I and class II
If platelet transfusion refractoriness does develop because of platelet- high-resolution matching on outcomes of unrelated donor bone marrow transplanta-
specific antibodies, compatible platelet products may be identified by tion: HLA-C mismatching is associated with a strong adverse effect on transplantation
using either platelet crossmatching or by accessing family member outcome. Blood 104:1923, 2004.
or other HPA-typed donors who are compatible with the patient’s 27. Petersdorf EW, Gooley T, Malkki M, Horowitz M: Clinical significance of donor-
recipient HLA matching on survival after myeloablative hematopoietic cell transplanta-
antibodies. 155,156 Platelet GP reactivity in transfusion recipients that lacks tion from unrelated donors. Tissue Antigens 69 Suppl 1:25, 2007.
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the binding of GPIIb/IIIa (α β ) (CD41/CD61) to fibrinogen. More- 30. Riley JP, Rosenberg SA, Parkhurst MR: Identification of a new shared HLA-A2.1
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