输注滤白血小板对患者HLA抗体产生的影响OA

Objective To investigate the factors associated with HLA antibody formation in patients undergoing platelet transfusion and to evaluate the intervention effect of leukocyte depletion technology.Methods The study enrolled 2 518 patients who received platelet transfusions from March 1,2021 to March 31,2025.HLA antibodies were detected using a solid-phase agglutination method.The effects of gender,age,the number of platelet transfusions,and leukocyte depletion on the formation of HLA antibodies were analyzed.Results Gender,age,and the number of platelet transfusions were i-dentified as independent risk factors for HLA antibody formation.Female patients exhibited a 1.64-fold higher risk com-pared to males(OR 1.64,95%CI 1.31-2.07).Compared with patients under 18 years of age,those aged 18-60 and over 60 showed a 35%and 40%reduction in antibody formation risk,respectively(OR 0.65,95%CI 0.50-0.86;OR 0.60,95%CI 0.44-0.83).Compared with patients who received single platelet transfusion,those with 2 and≥3 transfusions were associated with a 2.02-fold and 14.50-fold increased risk,respectively(OR 2.02,95%CI 1.49-2.74;OR 14.50,95%CI 11.16-18.84).The HLA antibody positivity rate was significantly higher in the non-leukocyte-depleted group(20.76%)than in the leukocyte-depleted group(14.31%)(χ2=12.27,P<0.01).However,after multivariate adjust-ment,absence of leukocyte depletion was not an independent predictor of HLA antibody formation.Interaction analysis be-tween the number of transfusions and leukocyte depletion revealed that:1)Among patients receiving 2 transfusions,no sig-nificant difference in antibody formation risk was observed between the group with 1 non-leukocyte-depleted transfusion and the fully depleted group(P>0.05),whereas the group with 2 non-leukocyte-depleted transfusions had a 1.64-fold higher risk(OR 1.64,95%CI 1.19-2.28);2)Among patients receiving≥3 transfusions,the groups with 1,2,and 3 non-leu-kocyte-depleted transfusion exhibited 25.45-,10.59-,and 11.45-fold higher risks,respectively(OR 25.45,95%CI 10.73-60.36;OR 10.59,95%CI 5.07-22.14;OR 11.45,95%CI 8.76-14.96),compared with the fully depleted group.In patients who received 1 platelet transfusion,compared with patients who received platelets filtered by the hospital blood bank,the risk of HLA antibody formation was reduced by 65%(OR 0.35,95%CI 0.18-0.69)in patients who re-ceived platelets filtered by the blood station.There was no statistically significant difference in the risk of antibody formation between the group that received platelets filtered twice by the hospital blood bank and the group that received platelets fil-tered once(P>0.05).Conclusion Female,younger age(under 18),and increased number of platelet transfusions are significant risk factors for HLA antibody formation.Leukocyte depletion effectively reduces the incidence of HLA antibody positivity.For female patients with a history of pregnancy and pediatric patients under 18 years of age,and patients receiv-ing≥3 platelet transfusions,leukocyte-depleted apheresis platelets from the blood station should be the preferred choice.