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Incidence of transfusion‐induced platelet‐reactive antibodies evaluated by specific assays for the detection of human leucocyte antigen and human platelet antigen antibodies
Author(s) -
FontãoWendel R.,
Silva L. C. N.,
Saviolo C. B. R.,
Primavera B.,
Wendel S.
Publication year - 2007
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/j.1423-0410.2007.00958.x
Subject(s) - antibody , platelet , antigen , immunology , medicine , platelet transfusion , incidence (geometry) , specific antibody , physics , optics
Background and Objectives The aim of this work was to study the incidence of transfusion‐induced platelet‐reactive antibodies in a selective patient population and evaluate different methodologies for platelet antibody screening (PAS). Materials and Methods The patients were retrospectively selected and divided into three separate groups: haematological malignancies (Group 1: n = 33); cardiac and orthopaedic patients (Group 2: n = 31) and a control group (Group 3: n = 23) selected with the same diagnoses of Group 2. PRE‐ and POST‐transfusion samples were tested for PAS by the following tests: PIFT (platelet immunofluorescence test), MAIPA (monoclonal antibody immobilization of platelet antigen), Flow PRA® and LCT (lymphocytotoxicity test). Results There was not a 100% concordance among the methodologies used. PIFT, MAIPA and Flow PRA presented very similar results whereas that of LCT differed from the other methods. A high rate of positive results (32%) was found in the PRE samples followed by an increase of almost 50% after blood transfusion (POST samples: 42·5% of positivity), but there was a statistical difference ( P < 0·05) between the PRE and POST transfusion sample only for the Flow PRA® technique tested on Group 2. Human leucocyte antigen (HLA) class I antibodies were present on 97·4% of POST positive samples, 5·4% presented anti‐human platelet antigen (HPA)‐1b antibodies and 8·1% presented a mix of panreactive antibodies against glycoprotein IIbIIIa, IaIIa and IbIX. Conclusions Blood transfusion did not increase the rate of alloimmunization in our haematological patients (Group 1); however, the patients were already admitted with a high rate of alloimmunization (12%). Group 2 patients are being immunized and the impact of this procedure remains to be studied as these patients may eventually undergo further hospitalization and receive more blood transfusion.