CROSS-MATCHED PLATELETS IN BONE-MARROW TRANSPLANTATION

Antibodies to HLA-antigens remain a problem in multiply-transfused pat ients. Over a 2 yr period 44 bone marrow transplant recipients were sc reened at weekly intervals for the presence of HLA-antibodies using a solid phase red cell adherence technique. An adaptation of this method was used to provide cross-matched random donor platelets (XMRDP) when screening proved positive. Twelve of the 44 patients were antibody po sitive, 6 prior to transplantation and 6 following the transplant. Tho se 4 patients who developed an antibody following the transplant had a significant increase in platelet increments following the change from random donor platelets (RDP) to XMRDP even though only one patient wa s refractory to platelets at the time the antibody was first detected. No significant bleeding occurred during the study period. The use of routine platelet antibody screening followed by platelet cross-matchin g allows excellent support of thrombocytopenic patients without requir ing HLA-typed blood donors and avoiding clinical platelet refractorine ss.