ORIGINAL PAPER: Incidence of transfusion-induced platelet-reactive antibodies evaluated by specific assays for the detection of human leucocyte antigen and human platelet antigen antibodies

• Published in: Vox sanguinis 2007-10, Vol.93 (3), p.241
• Main Authors: Fontão-Wendel, R, Silva, L C N, Saviolo, C B R, Primavera, B, Wendel, S
• Format: Article
• Language: English
• Subjects: Blood products; Blood transfusions; Medical screening; Patients
• ISSN: 0042-9007; 1423-0410
• DOI: 10.1111/j.1423-0410.2007.00958.x

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). 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 (registered trademark) and LCT (lymphocytotoxicity test). 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 dot 5% of positivity), but there was a statistical difference (P < 0 dot 05) between the PRE and POST transfusion sample only for the Flow PRA (registered trademark) technique tested on Group 2. Human leucocyte antigen (HLA) class I antibodies were present on 97 dot 4% of POST positive samples, 5 dot 4% presented anti-human platelet antigen (HPA)-1b antibodies and 8 dot 1% presented a mix of panreactive antibodies against glycoprotein IIbIIIa, IaIIa and IbIX. 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. [PUBLICATION ABSTRACT]