Platelet Immunology

Platelet Immunology Services provided by the Welsh Transplantation Laboratory

The Welsh Transplantation Laboratory provides specialist Platelet Immunology Services for patients in Wales. This includes performing laboratory investigations for:

  • Platelet Transfusion Refractoriness (PTR),
  • Foetal/Neonatal Alloimmune Thrombocytopaeinia (FNAIT),
  • Post-Transfusion Purpura (PTP),
  • Transfusion Relate Acute Lung Injury (TRALI),
  • Platelet Function Disorder

and the management of the provision of HLA/HPA selected platelets.

To find out more about these services please see our Service User Guide (see User Guide tab above), the All Wales Guideline for HLA and HPA Selected Platelets: Requesting and Feedback POL-WT-007 or contact the laboratory directly via email: WBS_SelectedPlatelets@wales.nhs.uk or telephone: 01443 622186.

 

Laboratory investigation request forms

For investigations relating to PTR, FNAIT, PTP, TRALI and platelet function disorder, please complete the Platelet and White Blood Cell Investigation Request Form located here:

This form collects the clinical information that enables us to ensure we perform the most appropriate tests for the patient and includes guidance in relation to the sample type and volumes required to enable us to complete this testing.  Also included is information in relation to minimal sample labelling requirements and where to send the samples for testing.  If you require any support in relation to this, please contact the laboratory directly (details can be found on the form).

 

Ordering HLA/HPA selected platelets

Platelets will be provided in accordance with the All Wales Guideline for HLA and HPA Selected Platelets: Requesting and Feedback POL-WT-007 following laboratory investigations for the presence of HLA/HPA antibodies.

 

Initial Requests

All initial requests for HLA/HPA Selected Platelets must be discussed with the Welsh Transplantation Laboratory.  Please telephone the laboratory directly on 01443 622186 (Monday-Friday, 9am-5pm)

Following discussion with the laboratory, complete all sections of the HLA/HPA Selected Platelets Provision Request Form 898-WTAIL, and email to the address indicated on the form.  Please ensure the form is completed in full as incomplete forms may lead to delays due to the need to confirm the additional information prior to approval of the request.

For prophylactic HLA selected platelet provision, please also provide a completed surgical treatment plan indicating planned platelet usage for the procedure.

Prophylactic HLA selected platelet provision is not recommended in the BSH guidelines for the use of platelet transfusions (Estcourt et al, 2016), however, the WBS has an agreement to provide HLA selected platelets for those patients diagnosed by an appropriate specialist in Wales, with certain platelet function disorders, as detailed in the All Wales Guideline for HLA and HPA Selected Platelets: Requesting and Feedback POL-WT-007.

 

Subsequent requests

Complete a HLA/HPA Selected Platelets Provision Request Form 898-WTAIL and email to the address indicated on the form.  Follow this up with a phone call to the laboratory to confirm receipt of the request and provision availability for the required dates.

 

Monitoring of HLA/HPA selected platelets provided for individual patients

It is vital that pre and post (10min to 1 hr) transfusion platelet counts are taken and reported back to the WBS using the HLA/HPA selected platelet feedback form 899-WTAIL. This allows us to assess the efficacy of the platelets transfused.  The results inform on ongoing appropriate unit selection to ensure we provide the best available platelets for the patient.