Abstract：
:Despite significant advancements in the production of platelet products, storage, and transfusion, transfusion refractoriness remains a significant clinical problem, affecting up to 14% of hematological patients receiving platelet transfusions. Human leukocyte antigen (HLA) alloimmunization is a major cause of immune platelet refractoriness, and its rate can be significantly reduced by implementation of leukoreduction. Despite promising preclinical results, pathogen reduction does not reduce HLA alloimmunization. Patients with HLA alloimmune refractoriness are usually managed with HLA-selected platelet transfusions. In this review, we describe the pathophysiology of HLA alloimmunization and alloimmune refractoriness, as well as options to prevent and treat these transfusion complications. We discuss the evidence supporting these options and point out the outstanding gaps. Finally, we review the possible future directions for prevention and treatment of alloimmune refractoriness.
journal_name
Transfus Med Revjournal_title
Transfusion medicine reviewsauthors
Saris A,Pavenski Kdoi
10.1016/j.tmrv.2020.09.010subject
Has Abstractpub_date
2020-10-01 00:00:00pages
250-257issue
4eissn
0887-7963issn
1532-9496pii
S0887-7963(20)30056-0journal_volume
34pub_type
杂志文章,评审abstract：:Hybridoma technology has contributed to virtually all areas of biology and medicine and set the scene for important advances in cell biology and immunodiagnostics. Blood transfusion and transfusion medicine have benefited significantly from development in hybridoma technology, and this has resulted in the generation o...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1053/tmrv.2002.33436
更新日期：2002-07-01 00:00:00
abstract：:Reasons for variation in transfusion practice in orthopedic surgery are not well understood. This systematic review identified and appraised the quality of the literature in this area to assess the impact of factors associated with the use of allogeneic red blood cell (RBC) transfusion in orthopedic procedures. MEDLIN...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2011.04.003
更新日期：2011-10-01 00:00:00
abstract：:Significant progress has been made in reducing the risk of pathogen transmission to transfusion recipients. Nonetheless, there remains a continuing risk of transmission of viruses, bacteria, protozoa, and prions to recipients. These include many of the viruses for which specific screening tests exist as well as pathog...
journal_title：Transfusion medicine reviews
pub_type： 共识发展会议,杂志文章,评审
doi：10.1016/j.tmrv.2007.09.001
更新日期：2008-01-01 00:00:00
abstract：:Millions of patients in the UK benefit from the use of both plasma derivatives and blood components that are seen as critical interventions in current medicine. Measures are in place to significantly reduce the risks associated with blood transfusion and plasma derivatives; however, these measures themselves are not r...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2011.09.003
更新日期：2012-07-01 00:00:00
abstract：:Studies of human herpesvirus-8 (HHV-8) transmission through transfusion have produced contradictory results. In North America-a region with a low prevalence of HHV-8 infection-3 studies that tested specimens from linked positive-donor/negative-recipient pairs collected before the introduction of white blood cell (WBC)...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2009.09.001
更新日期：2010-01-01 00:00:00
abstract：:With the realization that the skin bleeding time is often an unreliable measure of platelet function, efforts have been made to identify ways to assess qualitative platelet dysfunction. Currently available techniques measure platelet adhesion, platelet aggregation, the ability of platelets to retard or stop flow throu...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1053/tm.1997.0110106
更新日期：1997-04-01 00:00:00
abstract：:Until recently, atypical hemolytic uremic syndrome (aHUS), conventionally defined in the pediatric literature as a syndrome of the triad of renal failure, microangiopathic hemolytic anemia, and thrombocytopenia without a prodrome of hemorrhagic diarrhea, has received little attention in adult practice because the pati...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2014.08.004
更新日期：2014-10-01 00:00:00
abstract：:Although James Blundell is rightly acknowledged as the father of modern transfusion therapy, a review of the events surrounding the initial human-to-human transfusions in the first decades of the 19th century reveals substantial contributions by Blundell's collaborators. Bundell's uncle John Haighton provided substant...
journal_title：Transfusion medicine reviews
pub_type： 传,历史文章,杂志文章,评审
doi：10.1016/j.tmrv.2018.08.003
更新日期：2018-10-01 00:00:00
abstract：:Although the true risk of transmitting (classical) Creutzfeld-Jakob Disease (CJD) and variant CJD (vCJD) via transfusion is likely very minimal, a review of prions and the impact of these associated prion diseases is timely because of their current effect on safety policies in the blood-plasma industry. Various types ...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1053/tm.2001.25382
更新日期：2001-04-01 00:00:00
abstract：:The use of blood products to support patients undergoing the large variety of medical and surgical interventions requiring such support has continued to escalate very significantly over time. Relevantly, significant practice variation in the use of blood products exists among practitioners and institutions, largely be...
journal_title：Transfusion medicine reviews
pub_type：
doi：10.1016/j.tmrv.2010.05.002
更新日期：2010-10-01 00:00:00
abstract：:The chromosomal locations of genes controlling the expression of some 200 antigens constituting the 23 established human blood group systems have been reviewed. Twenty-one of the these genes are located on 12 autosomes, and two are located on the X chromosome. Refined chromosomal positions, to a single cytogenetically...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/s0887-7963(98)80056-4
更新日期：1998-07-01 00:00:00
abstract：:Metabolic studies have revealed a gradual impairment in platelet integrity during storage, a process termed the platelet storage lesion. Recent evidence shows that stored platelets also lose signaling responses to physiological agonists with impaired integrin activation, secretion, and aggregation of the cells. On the...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2007.05.004
更新日期：2007-10-01 00:00:00
abstract：:Controversial results exist regarding the clinical benefits of single- vs double-unit umbilical cord blood transplantation (UCBT) in patients with hematologic diseases. A systematic review was conducted to evaluate this issue. The PubMed, Embase, and Cochrane Library databases were searched up to May 2018. A total of ...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章
doi：10.1016/j.tmrv.2018.11.001
更新日期：2019-01-01 00:00:00
abstract：:Two complex protein defense systems-complement and coagulation-are based on amplifying enzyme cascades triggered by specific local stimuli. Excess systemic activation of either system is pathologic and is normally prevented by a family of regulatory proteins. The 2 systems are ancient biological processes which share ...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2019.08.004
更新日期：2019-10-01 00:00:00
abstract：:Prior preclinical and clinical studies support the use of platelet-derived products for the treatment of soft and hard tissue lesions. These regenerative effects are controlled by autocrine and paracrine biomolecules including growth factors and cytokines contained in platelet alpha granules. Each growth factor is inv...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2014.11.001
更新日期：2015-01-01 00:00:00
abstract：:In summary, it is impossible to reconcile the contradictory results of the studies of the association between previous blood transfusion and subsequent development of NHL (Figs 1 and 2). Most of the studies were of high quality, and the authors discussed the possible sources of bias that might have generated a spuriou...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1053/tm.20000.7395
更新日期：2000-07-01 00:00:00
abstract：:Some have suggested that "blood is different," and the role for cost-effectiveness is thus circumscribed. In this article, the authors start by reviewing key concepts in health economics and economic analysis methods. Examples are drawn from published blood safety studies. After explaining the underlying reasoning beh...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2008.09.001
更新日期：2009-01-01 00:00:00
abstract：:The use of prothrombin complex concentrates (PCCs) and fibrinogen concentrates (FIBCs) to achieve hemostasis in the perioperative setting as alternatives to allogeneic blood products remains controversial. To examine the efficacy and safety of PCCs and FIBCs, we conducted a systematic review-in accordance with the Pre...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2013.01.002
更新日期：2013-04-01 00:00:00
abstract：:Blood services around the world face increasing challenges in recruiting voluntary blood donors. With increasing donor restrictions and ageing populations, it is essential to look for any existing restrictions that may be relaxed in the light of currently available evidence. We propose that one such restriction is the...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2010.03.005
更新日期：2010-07-01 00:00:00
abstract：:Several public policy decisions in transfusion medicine require information on the long-term (> or =10-year) survival of transfused patients. This information is needed (1) to estimate the number of surviving transfusion recipients who have contracted a particular infection through transfusion, (2) to assess the cost-...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/s0887-7963(03)00019-1
更新日期：2003-07-01 00:00:00
abstract：:Roger Irving Lee (1881-1964) played significant scientific and leadership roles in overcoming the clinical impediments to blood transfusion in the 1910s. He developed the first successful anticoagulant system, paraffinized glass, and the first sterile system for indirect transfusion without defibrination, the Lee-Vinc...
journal_title：Transfusion medicine reviews
pub_type： 传,历史文章,杂志文章
doi：10.1016/j.tmrv.2004.09.003
更新日期：2005-01-01 00:00:00
abstract：:Low levels of C1 inhibitor, the main inhibitor of the classic complement system, result in paroxysmal angioedema attacks that can be incapacitating or even life-threatening in affected individuals. Molecular defects in the gene for C1 inhibitor cause hereditary angioedema. In recent years, new insights in the pathways...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2019.08.002
更新日期：2019-10-01 00:00:00
abstract：:Although the risk of infection by blood transfusion is relatively low, breakthrough infections still occur, Transfusion-related fatalities caused by infections continue to be reported, and blood is not tested for many potentially dangerous pathogens. The current paradigm for increasing the safety of the blood supply i...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2004.11.005
更新日期：2005-04-01 00:00:00
abstract：:The development and expansion of the CTS in Pittsburgh shows the feasibility of this transfusion medicine delivery system. Few of the changes driven by health care reform both improve patient care and reduce costs. When properly implemented, a CTS achieves these objectives, benefits the community as a whole, and enhan...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/s0887-7963(05)80051-3
更新日期：1995-04-01 00:00:00
abstract：:A number of molecules on the surface of red blood cells (RBCs) and platelets express antigenic activity. Various biochemical and molecular approaches have been used to determine the structure and possible function that these molecules have for their respective cell types. The existence of variant molecules and null ph...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2004.03.006
更新日期：2004-07-01 00:00:00
abstract：:Cardiac surgical patients are among the highest consumers of allogeneic red blood cells (RBCs) due to the prevalence of anemia and bleeding. Up until recently, there was a paucity of high-quality evidence informing transfusion decisions in this patient group which led to wide variability in transfusion decision making...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2017.06.001
更新日期：2017-10-01 00:00:00
abstract：:In the last half of this century, donor deferral registries have grown in size, scope, and importance for blood collection organizations and regulatory agencies. This has occurred despite the lack of direct evidence that, when used with all other methods, they contribute meaningfully to the safety of the blood supply....
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/s0887-7963(93)70131-5
更新日期：1993-04-01 00:00:00
abstract：:Allergic transfusion reactions (ATRs) are the most common adverse reactions occurring during transfusion of blood components. Although most reactions are mild and involve cutaneous manifestations, severe ATRs including life-threatening anaphylaxis may also occur. The mechanisms of ATRs are largely unknown because they...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2017.09.002
更新日期：2018-01-01 00:00:00
abstract：:The administration of blood products is a common, resource-intensive, and potentially problem-prone area that may place patients at elevated risk in the clinical setting. Much of the emphasis in transfusion safety has been targeted toward quality control measures in laboratory settings where blood products are prepare...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1016/j.tmrv.2006.08.007
更新日期：2007-01-01 00:00:00
abstract：:Knowledge of the molecular basis of the blood group systems has enabled the development of assays for blood group genotyping. At this time, polymerase chain reaction (PCR)-based assays validated on fetal material obtained by invasive means (chorionic villus sampling or amniocentesis) are available for all clinically r...
journal_title：Transfusion medicine reviews
pub_type： 杂志文章,评审
doi：10.1053/tmrv.2003.50001
更新日期：2003-01-01 00:00:00
