{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T06:28:06Z","timestamp":1786429686479,"version":"build-2736575974"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"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. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to investigate the distribution characteristics and clinical significance of human leukocyte antigen class I antibodies in patients with immune-mediated platelet transfusion refractoriness (PTR) in this region, and to evaluate the clinical utility of local serological cross-matching strategies for improving platelet transfusion efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted involving 229 patients who underwent platelet antibody screening. Platelet antibody screening and cross-matching were performed using solid-phase agglutination assays. Human leukocyte antigens (HLA) antibodies were detected via Luminex liquid bead array technology to obtain mean fluorescence intensity (MFI), and HLA class I antibody specificity was identified using Luminex single-antigen beads. The corrected count increment (CCI) was employed as the primary efficacy evaluation metric to compare the clinical outcomes among different transfusion strategy groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Subgroup analysis revealed: in the random transfusion group, the PTR incidence was 26.92% (7\/26), with a median 24 h CCI of 7.35 (3.03, 10.78); the cross-incompatible group showed a significantly higher PTR incidence of 80.0% (4\/5), with a median 24 h CCI of 0.00 (\u22122.54, 9.39); while the cross-compatible group had a PTR incidence of 22.72% (5\/22), with a median 24 h CCI of 8.11 (3.02, 12.30). The platelet antibody positivity rate was 20.96% (48\/229), with 62.5% (30\/48) originating from hematologic malignancies. Among these, HLA antibody positivity reached 75.61% (31\/41), with HLA class I antibodies accounting for 93.55% (29\/31). HLA-B locus antibodies were the most common. The maximum MFI of HLA class I antibodies was negatively correlated with the 24 h CCI (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      = \u22120.368,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.032). The area under the receiver operating characteristic was 0.825 (95% CI: 0.600\u20130.954), and the optimal cut-off value was MFI = 1,525.6 (sensitivity 71.50%, specificity 85.50%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study analyzed the distribution characteristics of HLA class I antibodies in suspected or highly suggestive immune-mediated PTR patients and found that the highest MFI value of HLA class I antibodies can serve as an indicator of the maximum observed HLA antibody reactivity. Based on a serological crossmatch transfusion strategy, this approach provides a feasible implementable platelet transfusion protocol for primary hospitals in southwestern China that lack HLA genotyping capabilities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1839846","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:37:33Z","timestamp":1786426653000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["HLA class I antibody distribution and cross-matching strategies in immune platelet transfusion refractory patients: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Yu","family":"Zou","sequence":"first","affiliation":[{"name":"Department of Blood Transfusion, Deyang People's Hospital","place":["Deyang, 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