{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T06:05:45Z","timestamp":1771221945866,"version":"3.50.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>A patient with myelodysplasia received a haploidentical hematopoietic stem cell transplant (HCT). Pre-transplant HLA antibody screening showed no detectable donor-specific antibodies (DSAs). Post-transplant, the patient developed an anti-HLA-A2 antibody, likely due to a memory B-cell response. This immune response led to platelet transfusion refractoriness and graft failure. The patient engrafted following a second stem cell infusion from the same haploidentical donor, using both HLA compatible platelets, to support initial platelet transfusion refractoriness (PTR) following primary stem cell infusion, and HLA-A*02 expressing platelets, to adsorb the circulating anti-A2 prior to the re-infusion.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1752791","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T05:18:59Z","timestamp":1771219139000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Study: HLA incompatible platelet infusion to allow emergency salvage HCT in a patient with primary graft failure due to donor specific HLA antibody"],"prefix":"10.3389","volume":"17","author":[{"given":"Louise","family":"Goddard","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Moses","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard Joseph","family":"Chu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert P.","family":"Carroll","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2024.09.005","article-title":"ASTCT consensus recommendations on testing and treatment of patients with donor-specific anti-HLA antibodies","volume":"30","author":"Kongtim","year":"2024","journal-title":"Transplant Cell Ther"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/tan.13741","article-title":"HLA antibodies in haematopoietic stem cell transplantation","author":"Little","year":"2019","journal-title":"HLA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1016\/j.jtct.2023.05.014","article-title":"Donor-specific HLA antibodies are associated with graft failure and delayed hematologic recovery after unrelated donor hematopoietic cell transplantation","volume":"29","author":"Lima","year":"2023","journal-title":"Transplant Cell Ther"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/tan.12040","article-title":"On the role of HLA antibodies in hematopoietic stem cell transplantation","volume":"81","author":"Brand","year":"2013","journal-title":"Tissue Antigens"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000545","article-title":"Memory B cells in transplantation","volume":"99","author":"Chong","year":"2015","journal-title":"Transplantation"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14669","article-title":"Heterogeneity of memory B cells","volume":"18","author":"Chong","year":"2018","journal-title":"Am J Transpl"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.23261","article-title":"Combination treatment of rituximab and donor platelets infusion to reduce donor-specific anti-HLA antibodies for stem cells engraftment in haploidentical transplantation","volume":"34","author":"Zhang","year":"2020","journal-title":"J Clin Lab Anal"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.674658","article-title":"Management of donor-specific antibodies in haploidentical transplant: multicenter experience from the madrid group of hematopoietic transplant","volume":"12","author":"Bail\u00e9n","year":"2021","journal-title":"Front Immunol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2017.10","article-title":"Effective desensitization of donor-specific HLA antibodies using platelet transfusion bearing targeted HLA in a case of HLA-mismatched allogeneic stem cell transplantation","volume":"52","author":"Yamashita","year":"2017","journal-title":"Bone Marrow Transpl"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1125367","article-title":"Anti-HLA Class I alloantibodies in platelet transfusion refractoriness: From mechanisms and determinants to therapeutic prospects","volume":"14","author":"Couvidou","year":"2023","journal-title":"Front Immunol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.exphem.2018.08.007","article-title":"Platelet engraftment after allogenic stem cell transplantation is monitored by digital polymerase chain reaction without interference by platelet support","volume":"68","author":"Doescher","year":"2018","journal-title":"Exp Hematol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0039.2012.01852.x","article-title":"HLA alloimmunization against platelet transfusions: pathophysiology, significance, prevention and management","volume":"79","author":"Pavenski","year":"2012","journal-title":"Tissue Antigens"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07189.x","article-title":"Platelet transfusion refractoriness","volume":"142","author":"Hod","year":"2008","journal-title":"Br J Haematol"},{"key":"B14","year":""},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2015.05.001","article-title":"Complement-binding donor-specific anti-HLA antibodies and risk of primary graft failure in hematopoietic stem cell transplantation","volume":"21","author":"Ciurea","year":"2015","journal-title":"Biol Blood Marrow Transpl"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2011.131","article-title":"Risk and prevention of graft failure in patients with preexisting donor-specific HLA antibodies undergoing unmanipulated haploidentical SCT","volume":"47","author":"Yoshihara","year":"2012","journal-title":"Bone Marrow Transpl"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.21307\/immunohematology-2020-034","article-title":"Elimination of HLA antibodies by platelet adsorption","volume":"36","author":"Jung","year":"2020","journal-title":"Immunohematology"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1111\/tan.13627","article-title":"Effective desensitization for a strong donor-specific HLA antibody in a case of HLA-mismatched allogeneic hematopoietic cell transplantation","volume":"94","author":"Misra","year":"2019","journal-title":"HLA"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-018-0220-7","article-title":"Depletion of donor-specific anti-HLA A2 alloantibodies in a hematopoietic cell transplant recipient using directed mismatched platelet transfusions","volume":"53","author":"Spriewald","year":"2018","journal-title":"Bone Marrow Transplant"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-019-0482-8","article-title":"Effect of low platelet HLA-C expression on donor-specific antibody depletion following platelet transfusion from a corresponding HLA donor","volume":"54","author":"Yamashita","year":"2019","journal-title":"Bone Marrow Transplant"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2015.292","article-title":"Post-transplantation-emerging anti-HLA DQA1\/DQB1 antibody possibly responsible for graft rejection after myeloablative-unrelated marrow grafting","volume":"51","author":"Yabe","year":"2016","journal-title":"Bone Marrow Transpl"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2018.08.009","article-title":"The association of de novo anti-HLA-DPB1 donor-specific antibody formation and primary graft failure after allogeneic hematopoietic cell transplantation","volume":"79","author":"Hefazi","year":"2018","journal-title":"Hum Immunol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.688987","article-title":"Memory B cells in pregnancy sensitization","volume":"12","author":"Nellore","year":"2021","journal-title":"Front Immunol"},{"key":"B24","volume-title":"Guidelines for Transfusion and Immunohaematology Laboratory Practice","year":"2025"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1752791\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T05:19:00Z","timestamp":1771219140000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1752791\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":24,"alternative-id":["10.3389\/fimmu.2026.1752791"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1752791","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,16]]},"article-number":"1752791"}}