{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:24:09Z","timestamp":1787016249560,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,9,28]],"date-time":"2017-09-28T00:00:00Z","timestamp":1506556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Platelet transfusion\u2013refractoriness is a challenging and expensive clinical scenario seen most often in patients with hematologic malignancies. Although the majority of platelet transfusion\u2013refractory cases are due to nonimmune causes, a significant minority are caused by alloimmunization against Class I human leukocyte antigens (HLAs) or human platelet antigens (HPAs). Such platelet transfusion\u2013refractory patients can be effectively managed with appropriate antigen\u2010negative products.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN AND METHODS<\/jats:title>\n                    <jats:p>Our institution has developed a diagnostic and management algorithm for the platelet transfusion\u2013refractory patient with an early focus on identifying those cases caused by immune\u2010mediated factors. Using physical platelet cross\u2010matches to initially classify platelet transfusion\u2013refractory patients as immune\u2010mediated or not, cross\u2010match\u2013compatible inventory is then provided to immune\u2010mediated patients, whereas subsequent HLA (with or without HPA) testing is performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Our blood donor program performs Class I HLA typing of all repeat platelet donors to facilitate the identification of antigen\u2010negative platelet units (virtual cross\u2010matching) as well as the recruitment of HLA\u2010matched donors. The platelet transfusion\u2013refractoriness algorithm realizes an initial net cost savings once two apheresis platelets are saved from use for each newly identified, immune\u2010mediated platelet transfusion\u2013refractory patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>An algorithm utilizing physical platelet cross\u2010matches, Class I HLA and HPA antibody testing, and upfront Class I HLA typing of platelet donors leads to overall resource savings and improved clinical management for platelet transfusion\u2013refractory patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.14316","type":"journal-article","created":{"date-parts":[[2017,9,28]],"date-time":"2017-09-28T12:05:17Z","timestamp":1506600317000},"page":"2828-2835","source":"Crossref","is-referenced-by-count":71,"title":["How do I \u2026 manage the platelet transfusion\u2013refractory patient?"],"prefix":"10.1111","volume":"57","author":[{"given":"Justin E.","family":"Juskewitch","sequence":"first","affiliation":[{"name":"Division of Transfusion Medicine Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"Norgan","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R.","family":"De Goey","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patti M.","family":"Duellman","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie L.","family":"Wakefield","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish J.","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Stubbs","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin D.","family":"Kreuter","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine Department of Laboratory 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