Platelet‐bound immunogloblins before and after platelet transfusion: measurement of in vivo binding

• Published in: British journal of haematology 1999-02, Vol.104 (2), p.397-402
• Main Authors: Levin, M‐D., De Vries, W., De Veld, J., Doekharan, D., Van Der Holt, B., Van 'T Veer, M. B.
• Format: Article
• Language: English
• Subjects: alloimmunization; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Autoimmunity; Biological and medical sciences; Blood Platelets - immunology; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Flow Cytometry; Hematologic Neoplasms - immunology; Hematologic Neoplasms - therapy; Humans; Immunoglobulin G - immunology; Medical sciences; platelet recovery; platelet transfusion; Platelet Transfusion - methods; platelet‐bound IgG; Random Allocation; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1046/j.1365-2141.1999.01177.x

In routine tests to investigate immunological mechanisms as a cause for enhanced destruction of transfused platelets, serum from the patient is tested against a panel of donor lymphocytes and platelets to demonstrate the presence of antibodies against HLA or platelet specific antibodies. Here we describe a flow cytometric technique in which in vivo binding of immunoglobulins (Ig) is measured. By comparing the histograms of the platelet suspensions before and after transfusion, four different patterns were obtained: no Ig binding before and after transfusion (pattern 1), pre‐existent Ig binding (patterns 2 and 3) or preferential Ig binding to the transfused platelets (pattern 4). This technique was tested in 164 random platelet transfusions and 34 HLA‐matched platelet transfusions. A statistically significant association was found between pattern 1 and a negative result of the indirect platelet immunofluorescence test for the detection of antibodies in the serum taken before the transfusion studied or a good platelet recovery and between pattern 4 and a positive indirect platelet immunofluorescence test or a low platelet recovery.