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Platelet Transfusion
• Platelet refractoriness: non-immune vs immune
• Immune platelet refractoriness
– HLA Abs (other Abs: plt-specific, drug-induced, ABO)
• HLA alloimmunization: due to allogeneic WBC exposure via prior transfusion or pregnancy (PLTs – class I only)
• Management: histocompat. PLTs
• Prevention: WBC-reduced blood
TRALI and HLA Antibodies
• Implicated components
– Ab anti HLA in blood donors (erythrocytes, platelets, plasma)
• TRALI risk: key factors
– Patient susceptibility – first hit
– Antibody presence and titer
– Antibody specificity – cognate pt Ag?
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