Genetics by genetic algorithm: Defining an ideal platelet donor population to support patients with HLA-mediated alloimmune refractoriness.
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| Title: | Genetics by genetic algorithm: Defining an ideal platelet donor population to support patients with HLA-mediated alloimmune refractoriness. |
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| Authors: | Blake JT; Dalhousie University, Halifax, Canada.; Canadian Blood Services, Ottawa, Canada., Rickards N; Canadian Blood Services, Ottawa, Canada., Mack J; Canadian Blood Services, Ottawa, Canada.; Department of Medicine, McGill University, Montreal, Canada., Seftel M; Canadian Blood Services, Ottawa, Canada.; Department of Medicine, University of British Columbia, Vancouver, Canada., Gupta A; Canadian Blood Services, Ottawa, Canada.; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada. |
| Source: | Transfusion [Transfusion] 2025 Dec; Vol. 65 (12), pp. 2398-2405. Date of Electronic Publication: 2025 Oct 08. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: American Association Of Blood Banks Country of Publication: United States NLM ID: 0417360 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1537-2995 (Electronic) Linking ISSN: 00411132 NLM ISO Abbreviation: Transfusion Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Arlington, Va. : American Association Of Blood Banks |
| MeSH Terms: | Algorithms* , Platelet Transfusion* , Blood Donors* , HLA Antigens*/immunology , HLA Antigens*/genetics , Blood Platelets*/immunology, Humans ; Canada ; Histocompatibility Testing ; Genetic Algorithms |
| Abstract: | Background: Immune factors underlie approximately 20% of patients exhibiting platelet transfusion refractoriness (PTR). PTR can be mitigated by supplying HLA-A and B compatible platelets to these patients. Since 2019, Canadian Blood Services has managed a program to provide compatible platelets to alloimmunized patients. This study evaluates donor pool size and ethnic diversity options to serve Canada's population. Study Design and Methods: We adapted simulation-based stem cell matching methods by generating simulated patients and matching them to existing and simulated donors using a Python algorithm. Recruitment scenarios included census-aligned, single-group, and meta-heuristic-optimized distributions to enhance match rates and equity. Results: More typed donors increase match rates, but rates vary significantly by ethnicity. Non-Black patients achieved 95% coverage with 13,000-18,000 new donors, whereas Black patients required ~55,000 new donors. Single-ethnicity recruitment improved the targeted group's rate but reduced overall match rates and disadvantaged other populations. A Pareto-optimal donor mix-augmenting Black, Hispanic, Asian Pacific Islander, and Native American/First Nations donors while modestly reducing White typing-preserved or improved rates but yielded only modest gains for Black patients. A balanced strategy further prioritizing Black and Hispanic donors with slight reductions in White, Asian, and Native American/First Nations typing achieved improvements for the Black population with minimal losses for others. Discussion: While Pareto-optimal allocation enhances overall efficiency, targeted trade-offs, focusing on underrepresented groups, are essential to correct persistent disparities and achieve equitable HLA-matched platelet availability. (© 2025 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB.) |
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| Grant Information: | RGPIN 03232 Natural Sciences and Engineering Research Council of Canada |
| Substance Nomenclature: | 0 (HLA Antigens) |
| Entry Date(s): | Date Created: 20251008 Date Completed: 20251215 Latest Revision: 20251217 |
| Update Code: | 20251217 |
| PubMed Central ID: | PMC12704696 |
| DOI: | 10.1111/trf.18446 |
| PMID: | 41059656 |
| Database: | MEDLINE |
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