Genetic Polymorphisms of HPA 1–6, 15 Systems in the Hangzhou Population and Their Role in the Management of Platelet Transfusion Refractoriness

Abstract

Background: The roles of human platelet antigens (HPAs) in the occurrence and management of platelet transfusion refractoriness (PTR) are still unclear. It is helpful to investigate the local genetic polymorphisms of HPAs and to evaluate the method of antigen match-compatible platelet transfusion aiming to mitigate platelet transfusion refractoriness. Methods: Polymerase chain reaction amplification with sequence-specific primers (PCR-SSP) was used to perform genotyping of the HPA 1–6, 15 systems in 400 platelet donors and 60 patients with positive platelet antibody screening results, and to analyze the effect of matched platelet transfusion in those patients. Results: In the HPA 1–6, 15 systems, allele “b” of HPA-3 was found to have the highest frequency of 0.51, and HPA-15 has the highest heterozygosity of 0.33. The rest HPA systems were dominated by “aa” homozygotes with over 90% genotype frequencies. The results of corrected count increment (CCI) in the antigen match-compatible transfusion group were significantly better than those in the random donor transfusion group (p < 0.05). Inside the match-compatible transfusion group, there was a difference between the cross-match-compatible transfusion group and the gene-match-compatible transfusion group, but no statistical significance (p > 0.1). Conclusions: The prevalence of HPAs in the local population is crucial in the understanding and management of platelet-related clinical disorders. According to the devised matching rules, a local database of platelet genes should be established to provide compatible platelet products to the alloimmunized patients. The safety and efficacy of platelet transfusion are expected to be improved, and in-depth research into blood transfusion can be advanced.