Tests regarding platelet refractoriness

When a patient is having platelet transfusion refractoriness that may be due to immunological causes, the patient’s HLA genotype and potential HLA antibodies must be analyzed (B –HLATrb, examination guidebook).

If the patient carries HLA antibodies that potentially explain the transfusion refractoriness, testing HLA-typed platelet products for the patient is recommended. However, a physician from the Blood Service should always be consulted before ordering HLA-typed platelets for the first time.

The tests are accreditated by FINAS accreditation services (Test laboratory T119, accreditation requirement SFS-EN ISO/IEC 17025:2017, SFS-EN ISO 15189:2013) and by the European Federation for Immunogenetics (EFI). The tests can be found in the examination guidebook (FI).

If poor responses to platelet transfusions are not explained by HLA antibodies, the Blood Service expert provides instructions on further testing. Potential HPA antibody tests are carried out by Fimlab Laboratories. When neonatal alloimmune thrombocytopenia (NAIT) is suspected, a Blood Service physician must be consulted before ordering HPA-typed platelets. All laboratory tests related to NAIT are carried out by Fimlab Laboratories.