Table 3.

Comparison of methods used to identify compatible platelet units for alloimmunized patients

CrossmatchedHLA matchedHLA compatible
Method Test patient’s serum against a panel of platelets to determine compatibility Identify platelet donors with perfect (4/4) match for patient’s HLA class IA and IB alleles ASP: Use antibody specificities to select donor units that lack corresponding antigens 
Pros • Rapid turnaround-time • 4/4 match ensures HLA compatibility • Larger donor pool 
• Obtain compatible units without HLA genotype or HLA antibody testing • Reduced risk of future alloimmunization • Reduced risk of future alloimmunization 
• Compatible with HLA and HPA antibodies   
Cons • Difficult to find compatible units for highly alloimmunized patients • HLA genotyping required • Not useful for HPA antibodies 
• Risk of alloimmunization for mismatched HLA antigens • Limited donor pool for some patients • HLA antibody testing required 
CrossmatchedHLA matchedHLA compatible
Method Test patient’s serum against a panel of platelets to determine compatibility Identify platelet donors with perfect (4/4) match for patient’s HLA class IA and IB alleles ASP: Use antibody specificities to select donor units that lack corresponding antigens 
Pros • Rapid turnaround-time • 4/4 match ensures HLA compatibility • Larger donor pool 
• Obtain compatible units without HLA genotype or HLA antibody testing • Reduced risk of future alloimmunization • Reduced risk of future alloimmunization 
• Compatible with HLA and HPA antibodies   
Cons • Difficult to find compatible units for highly alloimmunized patients • HLA genotyping required • Not useful for HPA antibodies 
• Risk of alloimmunization for mismatched HLA antigens • Limited donor pool for some patients • HLA antibody testing required 

Table adapted from Forest and Hod.

ASP, antibody specificity prediction.

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