This symposium will present an intermediate to advanced discussion of how clinicians, transfusion service personnel and HLA laboratory personnel can work together to provide effective, compatible platelet products for alloimmune refractory patients who require platelet transfusions. Newer, more sensitive methods for determining HLA antibody specificity, molecular methods for HLA and platelet antigen typing, and HLA and platelet crossmatching will be discussed. The results of an updated survey of blood centers that provide HLA-matched platelet products for alloimmune refractory patients will be summarized. Current practices for selection of platelet products for alloimmune refractory patients will be examined through the use of case studies. Some alternative approaches will be proposed.