RACIAL-DIFFERENCES IN THE AVAILABILITY OF HUMAN-LEUKOCYTE ANTIGEN-MATCHED PLATELETS

In view of the demonstrated difficulty of providing African American p atients with compatible red cells and bone marrow from the predominant ly white donor population in the United States, it should be determine d if African American patients have greater difficulty obtaining human leukocyte antigen (HLA)-matched platelets. Twenty-two alloimmunized A frican American patients and 20 alloimmunized white patients were stud ied. These groups were HLA-matched against our hospital pheresis servi ce (1,157 donors), the local Red Cross pool (3,405 donors), and the co mbined population (4,562 donors). The frequency of each patient's HLA phenotype was calculated in the white population and in the African Am erican population. More African Americans did not have a well matched (A or BU) platelet donor. Fewer African American patients had sufficie nt matched (A and B) donors to support the average period of aplasia. On average, the African American patients had half as many matched don ors as compared to the White patients. Sixty-eight percent of African American patients had HLA types which were more difficult to find in a white population. Ninety percent of white patients had HLA phenotypes which were more common in the white population. We have shown that it is more difficult to obtain HLA-matched platelets for alloimmunized A frican American patients as compared to alloimmunized white patients. With larger donor pools, platelet support for African American patient s is easier, but uncommon HLA types remain. Our results support effort s to enlarge the donor pool with an emphasis on specific recruitment p rograms aimed at the African American community. (C) 1996 Wiley-Liss, Inc.