ELISA, the least time-consuming test, detects alloimmunization as often as LIFT and more often than LCT and PIFT.

No abstract

Peritoneal macrophages from uninfected continuous ambulatory peritoneal dialysis (CAPD) patients in general show two different, endogenous peroxidase activity (PA) patterns: exudate and negative. This suggests, in accordance with the animal model, that these macrophages are changed proportionately in CAPD patients. This chronic change may be caused by mechanical stimulation alone (massage) or the composition of the dialysis fluid used. Therefore in the rat model both physiological saline and commercial dialysis fluid were intraperitoneally (i.p.) administrated. Our results on the PA-pattern of peritoneal macrophages do indicate that a single i.p. administration of commercial dialysis fluid induced an acute exudate, especially when compared with the minor saline effect. These results are confirmed by the percentage of macrophages positive for a differentiation antigen recognized by the monoclonal antibody ED2. In addition the percentage of Fc-receptor positive peritoneal cells is more enhanced after i.p. injection of dialysis fluid when compared with the saline effect. These findings strongly suggest that the dialysis fluid used in peritoneal dialysis patients is the inducer of exudate peritoneal macrophages in these patients.

Alloantibodies against HLA antigens can be reduced by applying leukodepletion to transfusions. Because the importance of immunological and nonimmunological causes of poor platelet transfusion results using leukodepleted transfusions is not clear, we conducted a prospective study in an unselected patient population receiving leukodepleted transfusions. In 97 patients with hematological malignancies, 181 random leukodepleted platelet transfusions were studied for immunological causes of poor platelet transfusion results by calculating the odds ratio of four different screening tests for a low platelet recovery. Nonimmune causes were also studied by calculating the odds ratio of the most prevalent nonimmune causes for a low platelet recovery. No single screening test showed an association with recovery after 1 and 16 h following a platelet transfusion. The combination of a positive enzyme-linked immunosorbent assay (ELISA) and platelet immunofluorescence test (PIFT) or a combination of a positive lymphocyte immunofluorescence test (LIFT) and PIFT, demonstrating an association with a low platelet recovery after 16 h, was present in 2% of all platelet transfusions. Of nonimmune causes, splenomegaly and storage time of platelets for more than 3 days were associated with low platelet recovery after 1 h and 16 h of being present in 29% and 47% of all platelet transfusions, respectively. Immunological causes account for a small proportion of poor platelet transfusion results compared to nonimmunological causes in a nonselected patient population receiving leukodepleted transfusions.

In a population at low risk for alloimmunization, the correlation of test outcome and platelet recovery is poor. None of these crossmatch tests or screening tests was identified as superior to any other in this population.