Antigenos Plaquetarios expo

8/17/2019 Antigenos Plaquetarios expo

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Prof. Boris Valdivia V

UNMSM - 2015

EsSaludMAS SALUD PARA MAS PERUANOS

ANTIGENOS PLAQUETAIOS

!UMANOS " PUEBA #E

$OMPATIBILI#A#

PLAQUETAIA


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A%&'('d'%&'s

) P*as +r'&ra%sf,sio%al's

solo s' r'alia% +ara los

'/a&i's) Uso d' Pla,'&as

so*r'+asa '% +ro/'dio

'l ,so d' (l,las roas.

) 1341-130 ,so d'

+la,'&as a,/'%&o d'

0.61 a 2.7 /illo%'s.


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A%&'('d'%&'s

) 13328 4.9 /illo%'s d'

,%idad's d' +la,'&as

f,'ro% &ra%sf,%didas.

) !NGAI8 12000-15000

+la,'&as:a;o

) 1310< #,='8 'fi(a(ia

&ra%sf,sio% +la,'&as) N,'vos &ra&a/i'%&os >

,so d' (o/+o%'%&'


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) ABO

) LEWIS

) I

) P

) ANTIGENOS PLAQUETARIOS ESPECIFICOS

o HPA 1 (PLA1

)o HPA 2, etc.

) ANTIGENOS HLA CLASE I


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Antigen! P"#$%et#&i!

Categoria I

A%&?@'%os d' ABO

A%&?@'%os L'< Ii P I%si@%ifi(a%&'sC

A%&?@'%os !LA< $las' I- so% si%&'&iados '%dD@'%a/'%&'> so% +ar&' d' la /'/*ra%a +la,'&aria.

Categoria II

Lla/ados !PA !,/a% Pla&'l'& A%&i@'%sFCA%&?@'%os '(l,sivos d' +la,'&as > /'@a=ario(i&os

So% +rod,(&o d' @'%'s alli(os


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I%/,%olo@?a Pla,'&aria

) Las GP fi@,ra% +ro/i%'%&'/'%&' (o/o aloa%&?@'%os<

a,&oa%&?@'%os > *la%(o d' a%&i(,'r+os d'+'%di'%&'s d'

fHr/a(os

) Los aloa%&?@'%os aso(iados a +la,'&a +,'d'% s'r (lasifi(ados

'% 2 @r,+os 8

) A%&?@'%o +la,'&ario %o 's+'(?fi(o< +r's'%&' '% las +la,'&as

> o&ros &i+os ('l,lar's

) A%&?@'%o 's+'(?fi(o +la,'&ario< ,%i(a/'%&' '+r'sado so*r'

las +la,'&as


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A%&i@'%os Pla,'&arios Es+'(?fi(os

) #' las do('%as d' GP d' /'/*ra%a +la,'&aria r'(o%o(idas< al

/'%os 5 GP Ia< I* alfa > *'&a C< II*< IIIa< > $# 103 C so%

+oli/Drfi(as > 's&H d'/os&rado ,' so% aloi/%,%o@%i(as

) E% la a(&,alidad s' a% d's(ri&o 29 APE< i%(l,>'%do s, lo(alia(iD%

's&r,(&,ral '% la GP d' /'/*ra%a +la,'&aria< (,a%&ifi(a(iD% d'

d'%sidad a%&i@%i(a so*r' la s,+'rfi(i' +la,'&aria > d'&'r/i%a(iD%d' +oli/orfis/o d' A#N '% los @'%'s ,' (odifi(a% los a%&?@'%os.

) P,'d' +r's'%&ars' isoi%/,%ia(iD% a ,%a s'&a @li(o+ro&'?%a la GP

IV $# 97 C ,' 's&H a,s'%&' '% al@,%os i%divid,os.

) A+ro. 9 5 J d' asia&i(os > %'@ros +r's'%&a% a,s'%(ia d' 's&a GP >

+,'d'% s'r s'%si*ilidos a GPIV a &ravs d' &ra%sf,siD% o '/*arao.


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A%&?@'%o +la,'&ario %o 's+'(?fi(o 8

) Es&os aloa%&?@'%os %o 's&H% r's&ri%@idos a li%a' +la,'&a

/'@a(ario(i&o ' i%(l,>'% 'l !LA > los d'&'r/i%a%&'s d' @r,+o

sa%@,?%'o ABO

) Las +la,'&as '+r'sa% a%&?@'%os !LA (las' 1 > %o a>

'vid'%(ia d' '+r'siD% d' ,' 'is&a /ol(,las !LA II

) Los A@ !LA $las' 1 so% al&a/'%&' +oli/Drfi(os > so%

(lasifi(ados (o/o A%&?@'%os A< B< > $

) La '+r'siD% d' 's&os a%&?@'%os so*r' las +la,'&as var?a > 's

i%fl,'%(iado +or 'l dosa' d' @'%'s


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) La (a%&idad d' A%&?@'%os !LA A > !LA B< 's al

/'%os 10 v'('s /a>or ,' la d' !LA $< ,' (,'%&a +ara

la *aa i%/,%o@'%'(idad d' a%&?@'%os !LA $

+la,'&arios

) Es&o a(' i%%'('sario &'s&'ar a%&?@'%os d'l lo(,s !LA $

'% la &ra%sf,siD% d' +la,'&as

) A%&?@'%os d'l @r,+o AB! so% '+r'sados +or ,% %K/'ro

d' GP +la,'&arias &al's (o/o GP I* V- I


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Sis&'/a A%&i@%i(o !LA !PA

) Varios a%&?@'%os +la,'&arios< al@,%os d' los (,al's so%

(o/+ar&idos +or o&ros li%a's ('l,lar's< &al (o/o ABO > !LA.Es&os A@ so% ,%a +ar&' i%&ri%s'(a d' la /'/*ra%a ('l,lar.

) El @r,+o /as @ra%d' d' a%&i(,'r+os r'a(&ivos 's&a diri@ido (o%&ra

a%&?@'%os !LA 1< (o/+ar&ido +or +la,'&as > (l,las *la%(as

) Es&os A(s so% los /as aso(iados (o% r'fra(&ari'dad +la,'&aria< ,''s la falla +ara o*&'%'r ,% ad'(,ado a,/'%&o d' +la,'&as l,'@o

d' ,%a &ra%sf,siD%

) S' d'&'(&a% +or +r,'*as d' li%fo(i&o&oi(idad

) A(s a%&i !LA s' +rod,('% '% +a(i'%&'s +oli&ra%sf,%didos >

/,'r's /,l&?+aras


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Pr'vi'%' aloi%/,%ia(iD% 8

) #'+l'(iD% d' l',(o(i&os) adia(iD% UV

) E+osi(iD% li/i&ada a /Kl&i+l's do%ador's +or ,so d' afr'rsis

A(s a%&i !LA +,'d'% s'r dif'r'%(iados d' A(s a%&i+la,'&arios

r'a(&ivos +or 'l &'s& MAIPA< ,' 's ,% '%sa>o 's+'(?fi(o +ara GP +la,'&aria

ad'/Hs s' d'/os&rD ,' 's /Hs s'%si*l' ,' la L$T '% la d'&'((iD% d'A(s a%&i !LA r'a(&ivo a +la,'&as


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ANTIGENOS

PLAQUETAIOS

ANTIGENOS ESPECIFICOS

INI$IALMENTE UEON EN$ONTA#OS EN PLAQUETAS. TAMBIEN

SE !A #EMOSTA#O EN $ELULAS EN#OTELIALES " MUS$ULO LISO.

SON GP #E LA SUPEAMILIA #E LAS INTEGINAS.


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ANTIGENOS PLAQUETARIOS

Es&r,(&,ras s,+'rfi(ial's d' MP< '+r'sadas +or Polisa(aridos aso(iados a GP

Ma>or +ar&' d'&'r/i%a%&'s a%&i@%i(os s' lo(alia% '% las GP

) So% r's+o%sa*l's d' la a+ari(iD% d' div'rsos (,adro (l?%i(os8

T&'citeni# nen#t#" #" * in'%ne

P+&% t&'citenic# !ttn!-%!in#"

Re#ccine! -e&i"e! n e'"/tic#! !t tn!-%!in#"e!

Re-ct#&ie0#0 # "# tn!-%!in 0e "#$%et#!

P+&% t&'citenic# #%tin'%ne

T&'citeni# in'%n #"&gic# c#%!#0# &

'e0ic#'ent!


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ISOANTIGENOS

$LASII$A$ION8

ISOANTIGENOS QUE SIMULAN ALOANTIGENOS 8 &odas las

+la,'&as so% i%(o/+a&i*l's

AUTOANTIGENOS 8 r'la(io%ados (o% GP II*-IIIa

$IPTOANTIGENOS 8 A@ T%d'f. N-a('&il@al(-&raC

ENOANTIGENOS 8 d'fi%idos +or s,'ros d' +ro('d'%(ia

a%i/al ISOANTIGENOS ELA$IONA#OS $ON ME#I$AMENTOS 8 i%d,-

(ida +or al@K% /'di(a/'%&oi%/,%o(o/+l'os< adsor(iD% >

+or a((iD% a,&oi%/,%'.


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!PA-1

!PA-6

!PA-7

!PA-4

!PA-

!PA-10

!PA-9

Aloa%&i@'%o MA

!PA-5

!PA-2

$o/+l'o @li(o+ro&'i(o

II* : IIIa

II* 9

GP Ia : IIa

9 1

GP I*

ALOANTIGENOS


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CCC

GCC

C

G

(407)

(407)

Prolina

Alanina

IIIaPA!7a

PA!7"

PA!7

CGG

CAG

G

A

(4#$)

(4#$)

Ar%inina

Glu&a'ina

IIIaPA!a

PA!"

PA!

GAGAAG

GA

(0)(0)

Glu&a'inaLisina

IaPA!aPA!"

PA!

CGA

CAA

G

A

(*4+)

(*4+)

Ar%inina

Glu&a'ina

IIIaPA!4a

PA!4"

PA!4

ATC

AGC

T

G

(#4+)

(#4+)

Isol,u-ina

S,rina

II"PA!+a

PA!+"

PA!+

ACG

ATG

C

T

(*4)

(*4)

Tr,onina

.,&ionina

I"PA/a

PA!"

PA!

CTG

CCG

T

C

(++)

(++)

L,u-ina

Prolina

IIIaPA!*a

PA!*"

PA!*

Codon1as,Posi-ionA'inoa-idoGli-o2ro&,inaAn&i%,noSis&,'a


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) Los a%&?@'%os r'+r's'%&ados '% la /'/*ra%a

+la,'&aria s' '%(,'%&ra% dis&ri*,idos '% &r's

sis&'/as8) A,'llos ,' s' '+r'sa% '(l,siva/'%&' '%

+la,'&as los lla/a/os !PA A%&?@'%os Pla,'&arios

!,/a%os C > lo (o%s&i&,>'% 26 aloa%&?@'%os .

) Los +r's'%&'s &a/*i% '% l',(o(i&os '% ,% &o&al d' 5lla/ados !LA d'l &i+o I A< B > $C .

) A%&?@'%os ,' s' alla% dis&ri*,idos '% o&ras (l,las<

(o/o +or ''/+lo '% los 'ri&ro(i&os< lla/ados@'%ri(a/'%&' a%&?@'%os %o +la,'&arios 's+'(?fi(os

ANPEC '% ,% &o&al d' 7 sis&'/as


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) Los aloa%&?@'%os d' +la,'&as s' a@r,+a% '% 2 @ra%d's

(a&'@or?as8

) Los 's+'(?fi(os d' 's&as (l,las< '%&r' los ,' s' '%(,'%&ra% los

A@s !PA-1< !PA-2 !PA-9< !PA-6< !PA-5< !PA-7< !PA-4<

!PA-

) > !PA-10 ,' 's&H% lo(aliados '% las @li(o+ro&'?%as d'

/'/*ra%a II* IIIa > Ia Iia

) Los (o/+ar&idos (o% o&ros &'idos (o/o los a%&?@'%os

'ri&ro(i&arios ABO > las /ol(,las !LA (las' I


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I/+or&a%(ia d' los A%&?@'%os Pla,'&arios

) Ti'%'% i/+or&a%(ia f,%da/'%&al '% 'l (a/+o d' lai%/,%o'/a&olo@?a > &ra%s+la%&' d' Dr@a%os.

) Ad'/Hs so% r's+o%sa*l's d' ,%a @ra% div'rsidad d'

&ras&or%os ,' va% d'sd' las aloi%/,%isa(io%'s f'&o/a&'r%as

> &ra%sf,sio%al's as&a las (i&o+'%ias a,&oi%/,%'.) So% a%&i(,'r+os ,' s' ,%'% a las +la,'&as< lo ,' +,'d'

o(asio%ar ,% a,/'%&o '% la d's&r,((iD% d' las /is/as. Es&o

+rovo(a ,% *ao (o%&'o d' +la,'&as &ro/*o(i&o+'%iaC >

+,'d' 's&ar aso(iado (o% sa%@rado.


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I/+or&a%(ia d' los A%&?@'%os Pla,'&arios

) E% 'l (aso d' las dro@as 's&as s' ,%'% a las +ro&'?%as d' la

/'/*ra%a +la,'&aria /odifi(a%do s, 's&r,(&,ra lo ,' a('

,' 'l sis&'/a i%/,%' %o las r'(o%o(a.

) Es&os a%&i(,'r+os +,'d'% s'r i%d,(idos +or 'l ,so d' al@,%os

/'di(a/'%&os'+ari%aC o la s'%si*ilia(iD%.

) Es&os a(&Ka% (o/o (rio@l,&i%i%as >a ,' la /a>or?a d' las v'('s

solo s' a(&iva% a &'/+'ra&,ra a/*i'%&' > %o a 94R$


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Aloi%/,%ia(iD% Pla,'&ariafa(&or's a &'%'r '% (,'%&a 8

) r'(,'%(ia > (a%&idad d' '/o(o/+o%'%&'s &ra%sf,%didos

) $o/*i%a(iD% d' '/o(o/+o%'%&'s &ra%sf,%didos

) #ia@%Ds&i(o d'l +a(i'%&'

) M'di(a/'%&os i%/,%os,+r'sor's ,sados

) a(&or's @'%&i(os ,sados

) #?fi(,l&ad '% dia@%os&i(ar fa(&or's ,' af'(&a% la r's+,'s&a a&ra%sf,(io%'s d' +la,'&as

) N'('sidad d' dif'r'%(iar '%&r' +a(i'%&'s ,' so% r'fra(&orios

d'*ido a /'(a%is/os I%/,%'s o No-I%/,%'s


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EA$TAIE#A#.- $a,sas

) NO INMUNES

Es+l'%o/'@alia

i'*r'< I%f'((io% $I#

!'/orra@ia

$alidad d' +la,'&as

&ra%sf,%didas S'+sis

#ro@as

) INMUNE

AloI%/,%ia(iD% a8

) !LA) Pla,'&arios

) ABO

A,&oa%&i(,'r+os

M'di(a/'%&os) $o/+l'os i%/,%'s

(ir(,la%&'s


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#ia@%Ds&i(o d' aloi%/,%ia(iD%

) Es *asado '% la d'&'((iD% d' a%&i(,'r+os (o%&ra

+la,'&as > l',(o(i&os o/Dlo@os

) Pr's'%(ia d' a%&i(,'r+os li%fo(i&o&Di(os'vid'%(ia aloi%/,%ia(iD% (o%&ra a%&?@'%os d'l

sis&'/a !LA.

) A%&i(,'r+os a%&i+la,'&arios so% d' %a&,ral'a

Aloi%/,%' o A,&oi%/,%'


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Id'%&ifi(a(iD% d' A%&i(,'r+os A%&i+la,'&arios

) I%/ovilia(iD% d' a%&i(,'r+os /o%o(lo%ar's

MAIPAC

) Ad'r'%(ia a 'ri&ro(i&os '% fas' sDlida) E%i/o i%/,%o'%sa>os ELISAC

) #'%si&o/'&r?a d' fl,o

) $orr'la(iD% (o% la (l?%i(a


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Pri%(i+al's r'a((io%'s +os&-&ra%sf,(io%al's

d'*idas a a%&i(,'r+os o a%&?@'%os

+la,'&arios

) 'a((iD% '*ril No !'/ol?&i(a

) P,r+,ra Tro/*o(i&o+%i(a Pos&Tra%sf,sio%al


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Pa&olo@?as Prod,(idas +or A%&i(,'r+os

A%&i+la,'&arios

) La &ro/*o(i&o+'%ia a,&oi%/,%' TAIC

) La &ro/*o(i&o+'%ia %'o%a&al aloi/,%' TNAIC

) PKr+,ra &ro/*o(i&o+'%ia +os&ra%sf,sio%al PTPC

) 'fra(&ari'dad a las &ra%sf,sio%'s d' +la,'&as

) La &ro/*o(i&o+'%ia i%d,(ida +or fHr/a(os


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M&odos d' La*ora&orio +ara I%v's&i@ar

'l Sis&'/a !LA

Mediante anticuerpos :

SEROLOGIA (Microlinfocitotoxicidad, ELISA,

Citometría de lu!o,etc"

#IOLOGIA MOLEC$LAR:

%CR&SS%, %CR&SSO


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Mi(roli%fo(i&o &oi(idad

) TIPII$A$ION !LA $LASE I

) TIPII$A$ION !LA $LASE II

) PUEBA $UA#A TISULA $OSS MAT$!C

) PANEL #E ANTI$UEPOS EA$TIVOS PAC


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T'(%olo@?a d' as' SDlida

) T'(%olo@?a 's&a *asada '% las +ro+i'dad's ,' +os''% los

+lHs&i(os +ara irr'v'rsi*l'/'%&' a*sor*'r > '%laar

+ro&'?%as > o&ros (o/+,'s&os ,?/i(os.

) A*sor(iD% 's %o 's+'(?fi(a

) Pro&'?%as o (o/+,'s&os ,?/i(os a s'r ,sados d'*'% s'r +,rifi(ados a%&'s d' s'r a;adidos al so+or&' sDlido

+lHs&i(oC.


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Sis&'/as d' as' SDlida

M'/*ra%as ('l,lar's o +ar&?(,las i%f'((iosas so% ad'ridas a

,% so+or&' sDlido a%&'s d' i%i(iars' la +r,'*a. El (o/+o%'%&' i%/o*iliado +,'d' s'r ,% a%&?@'%o o ,%

a%&i(,'r+o d'+'%di'%do d'l +ro+Dsi&o d' la +r,'*a.

El r'a(&a%&' ad'rido al +lHs&i(o sirv' +ara (a+&,rar 'l

(o/+o%'%&' 's+'(?fi(o ,' 's *,s(ado '% la /,'s&ra 'val,ada.

Es&' (o/+o%'%&' 's (a+&,rado o a&ra+ado '% 'l so+or&' sDlido. U% sis&'/a i%di(ador 's ,sado +ara d'/os&rar ,' la r'a((iD%

d's'ada a o((,rido.


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Pruebas de Compatibilidad en

Fase Sólida) #'&'(&a a%&i(,'r+os !LA as? (o/o

a%&i(,'r+os (o%&ra a%&?@'%os +la,'&arios

's+'(?fi(os > a%&i(,'r+os I@G (o%&raa%&?@'%os A > B

) U&ilia +la,'&as fr's(as o (o%s'rvadas +ara

las +r,'*as d' (o/+a&i*ilidad


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Pruebas de Compatibilidad Pruebas de Compatibilidad

Plaquetaria Plaquetaria

) Pro+or(io%a% a>,da '% la s'l'((iD% d'

do%a%&'s +ara 'l +a(i'%&' r'fra(&ario) Ar&?(,los s';ala% la i%'fi(a(ia d' las

&ra%sf,sio%'s d' +la,'&as s'l'((io%adas

'(l,siva/'%&' '% *as' a +r,'*as d' !LA


41/49

Pr,'*as d' $o/+a&i*ilidad '% as'

SDlida

I%(,*ar

Lavar

'

' ' ' ' ' ' ' ' ' ' '

' ' '

' ' ' '

'

'

' ' '

' '

' '

'

' ' '

' '

' ' ' ' ' ' ' ' ' ' '

' ' '

' '

' '

' '

' '

LISS S,'ro+



42/49

+

!'/a&?'s

i%di(ador's

$'%&rif,@ar

Posi&ivo

f,'r&'

Posi&ivo

d*il

N'@a&ivo


SDlida


43/49

I%/ovilia(iD% d' A@ +la,'&arios 's+'(?fi(os (o%

A( /o%o(lo%al's

Pri%(i+l' of &' Mo%o(lo%al

A%&i*od> I//o*ili'd Pla&'l'&

A%&i@'% MAIPAC &'s&

a%&i@'%s o% +la&'l'& /'/*ra%' ar'

r'(o@%i'd *> a ,/a% !C a%d a/o,s' MC a%&i*od> 9C a%&i@'%

a%&i*od> (o/+l' is sol,*ili'd a%d

disi%&'@ra&'d +la&'l'&s r'/ov'd 6C

Goa& a%&i*odi's (oa&i%@ &'

/i(ro+la&' i//o*ili' +la&'l'&

a%&i@'%s a%d 5C a s'(o%d @oa&a%&i*od>< (o,+l'd &o a% '%>/'<

*i%ds &o &' ,/a% a%&i*od>. U+o%

addi&io% of s,*s&ra&'< (olor is

@'%'ra&'d


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MASPAT

T(%i(a d' ad'r'%(ia 'ri&ro(i&aria '% fas' sDlida

) Mo%o(a+a d' +la,'&as d' do%a%&'

i%/oviliada +or ('%&rif,@a(iD% a la s,+'rfi(i'

d' +o(illos r'(,*i'r&os d' A( /o%o(lo%al's d'

ra&D% +la,'&a 's+'(?fi(os .


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T(%i(a MASPAT C

P"#$%et# 0e" 3n#nte

GR humanos sensibilizados con Ig G

Anti – Ig G monoclonal de ratón

Ac. Plaquetario del suero del paciente

Ac monoclonal plaqueta específico

F#!e S"i0#


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4ASPAT

) M,'s&ra8 s,'ro< ST (o% E#TA

) PP8 do%a%&'s d' @r,+o ABO

) PBS8 sol,(iD% d' lavado

) $'%&r?f,@a +ara /i(ro+la(as

) I%(,*ador s'(o a 94$

) $loro,i%a

Tra&a/i'%&o (o% (loro,i%a

) Es&a &(%i(a s' ,&ilia +aradif'r'%(iar A( !LA d' A( !PA

S%e& P"#$. tt#0#! P"#$. N tt#0#!

$ar'%&' d' A$ 5

A%&i !LA 5 5

A%&i !PA 5


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.

EPOTES #E INTEES

) S'l'((iD% d' Pla,'&as +or !LA %o 's 'i&osa '%

20 a 90J d' (asos Tra%sf,sio% 135C

) La*ora&orios (o/*i%a% +r,'*as d' (o/+a&i*ilidad +la,'&aria (o% +r,'*as d' !LA '% la s'l'((iD% d'

+la,'&as a s'r &ra%sf,%didas.

) ri'd*'r@ > (ol'@as d'/os&raro% ,'8134 !LA $o/+a&i*l'< +rod,o $$I '% 90J

!PA $o/+a&i*l'< +rod,o $$I '% 70J


49/49

$o%(l,sio%'s

) $o%&ri*,>'% al dia@%Ds&i(o d' aloi%/,%ia(iD% +la,'&aria

) P'r/i&' la *,s,'da d' (o%('%&rados +la,'&arios

(o/+la&i*l's

) P'r/i&' la i%divid,aliaviD% d' '/*araadas (o% +o&'%(ial

d' TAIN

) P,'d'% (o/+l'/'%&ar 'i&osa/'%&' las +r,'*as d' +ar'o

!LA

) Pr'di('% /'or 'l i&o d' &ra%sf,sio%'s d' +la,'&as

) Ofr'('% ,% /&odo si/+l' > (o%fia*l' +ara la id%&ifi(a(iD%

d' do%a%&'s (o/+a&i*l's

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