A patient has poor corrected count increments after two ABO-compatible platelet transfusions. Fever, bleeding, DIC, and splenomegaly are excluded, and strong HLA class I antibodies are detected. Which product strategy is most appropriate?
1Continue random donor platelets without antibody screening or monitoring for reactions
2Use washed red blood cells instead of platelets to avoid HLA antibodies
3Select only RhD-negative plasma products to reduce alloimmunization risk
4Provide compatible platelets selected by HLA matching or antibody specificity✓ 정답
해설
When nonimmune causes are excluded and HLA antibodies support immune refractoriness, HLA-matched or antibody-compatible platelets can improve the chance of an adequate increment.