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.