الفهرس 
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Abstract
The refractoriness to platelet transfusion is a complicated problem to the treating physician and blood transfusion service with an incidence varying from 5% to 14% in hematology patients. Additionally, platelet refractoriness generates a significant economic burden with higher hospitalization costs than non refractory patients. Refractory patients are exposed to an increased risk of clinically significant bleeding and need proper management.
Platelet refractoriness is simply described as a lower-than-expected post transfusion platelet increase. PTR is caused by a variety of factors, with non-immunological causes accounting for 80% of cases and immunological causes accounting for 20% of cases. Immunological causes include the existence of antibodies to human leukocyte antigens (HLA) and/or human platelet antigens (HPA). Patients who have been repeatedly transfused face a higher challenge, with 30–70 percent of them becoming resistant to random donor platelet transfusions.
Two basic options for transfusing alloimmunized patients: giving HLA-matched platelets or giving cross match compatible transfusions. Platelet cross matching provides a quick and effective donor platelet selection and can be completed in a matter of hours.
Another advantage of cross-matching is the broader pool of compatible donors available compared to HLA matched platelets. To identify compatible platelet donors, many cross matching approaches have been developed, including radioactive techniques, flow cytometry, enzyme-linked immunosorbent assay (ELISA), and solid-phase assays.
The development of the solid-phase red cell adherence assay (SPRCA) made it easier for many blood centers to do platelet crossmatching in huge numbers and in a short amount of time.
The present study was conducted on 40 patients having different hematological disorders attending Alexandria main university hospitals who were refractory to platelet transfusions. The patients received 60 platelet transfusions and platelet cross matching using SPRCA technique was used to screen for anti platelet antibodies on the transfused platelets.
Screening and quantitative estimation of anti- HLA antibodies by ELISA technique was also done.