There are Platelet Antibodies Too?!

Yes, you heard me right! Red blood cells are not the only type of cell which can be affected by clinically significant alloantibodies. Patients can develop alloantibodies (and autoantibodies) against different platelet antigens which can affect their platelet count and function.

Platelet refractoriness is important to the practice of transfusion medicine, because these patients can have continued thrombocytopenia (low platelet counts) despite receiving multiple platelet transfusions. Unfortunately, platelet alloantibodies can significantly affect patient outcomes because persistent thrombocytopenia may result in spontaneous bleeding. Not good! This can also impact limited platelet resources and contribute to a prolonged and expensive hospital stay.

Somewhat like red blood cell alloantibodies, Carter BloodCare can perform a platelet antibody screen to identify clinically significant platelet alloantibodies- you can see a picture of our platelet antibody screen being interpreted in the above image! This is an ELISA test which can identify the presence of both anti-human leukocyte antigen (HLA) and anti-human platelet antigen (HPA) antibodies – 2 significant causes of immune-mediated platelet refractoriness. It’s important to remember that platelets also have ABO antigens on their surface, so anti-ABO antibodies can also be a potential cause of poor post-transfusion platelet increment.

Carter BloodCare is very dedicated to providing specialized platelet products to patients with immune-mediated platelet refractoriness. We have an in-house platelet matching specialist, Stan Hance (see his picture above!), who provides matched platelets to local patients in need as well as patients outside of Texas.

We work with volunteer platelet donors with known HLA and HPA antigen types who will come donate if a patient needs a platelet that matches their specific type. We are so lucky to have dedicated and generous donors who volunteer their time and energy to help these patients in need! 

When it comes to finding the best possible platelet transfusion for the patients we serve, we try our best to use our laboratory services to identify platelet antibodies and our donor database to provide specialized units to help support our hospital patients.

References:

1.      Juskewitch, Norgan and De Goey et al. How do I . . . manage the platelet transfusion–refractory patient? Transfusion 2017; 57: 2828–2835.

2.      Stanworth, Navarrete, Estcourt et al. Platelet refractoriness--practical approaches and ongoing dilemmas in patient management. Br J Haematol. 2015; 171 (3): 297-305.