(P-TS-23) Class I HLA Alloimmunization Status is Not Associated with Volume of Platelets Transfused During Liver Transplantation: A Single Center Experience
Background/Case Studies: A p</span>anel-reactive antibody testfor detection of antibodies to Class Iand II HLA (PRA I / II) is routinely performed prior to liver transplantation at our center. Patients with anti-HLA Class I antibodies can be platelet refractory. The purpose of this study wasto determine if Class I HLA alloimmunization status is related to the volume of platelets transfused within 24 hours of liver transplantation,and to apply thestudy resultsto blood bank platelet inventory management in this setting.
Study
Design/Methods: A retrospective study of 96 consecutive liver allograft recipients was performed.The demographic and laboratory data were obtained from the electronic medical record and HLA laboratory information system review. Flow cytometric, bead-basedPRA assaywas employed in all cases included in the study.PRA I >/= 20% was used to define clinically significant sensitization to Class I HLA in the given setting. Descriptive statistics and the Mann-Whitney U test were used for data analysis.
Results/Findings: The population consisted of 52 male and 44 female patients, ranging in age from 25 to 72 (median 57.5 years), with diagnoses of alcoholic cirrhosis (39.6%), non-alcoholic steatohepatitis (26.0%), viral hepatitis (14.6%), and other, less common diagnoses (19.8%). The racial makeup of the population was 56.3% Caucasian, 29.1% Hispanic, 10.4% African-American, and other (4.2%).The patients’ pre-operative platelet count ranged from 19 – 308 K / uL (median: 73 K/uL). The volume of platelets transfused ranged from 0 – 2400 mL (mean: 586 mL, median: 600 mL). 25/96 (26.0%) of individuals did not receive platelets (0 mL transfused)within the 24-hour period.66 patients had a PRA I of 0%, considered to be non-HLA Class I alloimmunized. The remaining 30 patients had a PRA I greater than 0%, thus class I alloimmunized. Of the latter group, 20 patients (66.7%) had a PRA I>/= 20%. The cohort with PRA I>/= 20% (n=20)received 0 – 1800mL platelets (mean:700 mL, median: 726 mL). The cohort with 0-20% PRA I(n=76) received 0 -2400 mL platelets (mean:557 mL, median: 505mL).There was no significant difference in the volume of platelets transfused between the two groups (p=0.1759). Conclusions: Class I HLA alloimmunization status was not related to volume of platelets transfused within 24 hours of liver transplantation based on the current study.PRA I may not aid in blood bank inventory management in preparation for liver transplantation.
