Febrile, Nonhemolytic Transfusion Reactions and the Limited Role of Leukoagglutinins in Their Etiology

Kevy, Sherwin V.; Schmidt, Paul; McGinniss, Mary H.; Workman, W. G.

doi:10.1111/j.1537-2995.1962.tb00187.x

Cited by 63 publications

(17 citation statements)

References 16 publications

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“…In the absence of any demonstrable red cell incompatibility, it is often assumed that such reactions are due to leukocyte antibodies, or "leukoagglutinins." One recent study (20), however, showed that febrile transfusion reactions do not correlate well with the presence of leukoagglutinins in the recipients' serum. Undoubtedly transfusion reactions can be caused by leukocyte antibodies.…”

Section: Resultsmentioning

confidence: 99%

Platelet Sequestration in Man. II. Immunological and Clinical Studies*

Aster¹,

Jandl²

1964

J. Clin. Invest.

136

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The mechanisms of platelet destruction and their sites of sequestration in disease states are poorly understood. Although recent studies have emphasized the importance of platelet isoantibodies in certain clinical situations (1-3), little is known of the effects of antibodies on platelets in vivo. In conditions such as idiopathic thrombocytopenic purpura, there is debate as to whether immune mechanisms are involved, and sites of platelet sequestration are unknown.The availability of a method for labeling platelets with Cr5' that allows most of the transfused platelets to remain viable and reduces the initial deposition of nonviable platelets in the liver and spleen (4) permits study of some of these aspects of platelet pathophysiology. We investigated the survival and sites of sequestration of platelets exposed to isoantibodies in vivo. Included in this paper are observations of pyrogenic reactions after immune platelet destruction. Studies in patients with idiopathic thrombocytopenic purpura and other platelet disorders are also described. MethodsPreparation and transfusion of Cr51-!abeled "citrate platelets" and determination of the percentage of platelet survival were as described in the preceding report (4). In "extracting" Cr51-labeled platelets from blood samples taken from thrombocytopenic persons, nonradioactive platelets were added to the platelet-rich plasma to facilitate recovery of platelet Cr51. For isologous transfusions, only platelets from donors compatible with the recipients' ABO and Rh blood types were used.Methods of scintillation scanning over organs to evaluate sites of platelet sequestration have been described

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Section: Resultsmentioning

confidence: 99%

Platelet Sequestration in Man. II. Immunological and Clinical Studies*

Aster¹,

Jandl²

1964

J. Clin. Invest.

136

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“…Other known risks such as HLA antibodies which have also been reported to be responsible for hyper sensitivity reactions [12,13] in the blood products or in the recipient's serum, and bacterial contamination of the transNonhemolytic transfusion reactions (NHTRs) after blood component transfusion are observed in frequencies from 1 to 3% [1], The symptoms vary from mild forms, such as discomfort and urticaria, to severe reactions like anaphy lactic shock symptoms [2]. Although these reactions are well studied and well documented, little is known about their pathophysiology.…”

Section: Introductionmentioning

confidence: 99%

Impact of Allergy Screening for Blood Donors: Relationship to Nonhemolytic Transfusion Reactions

Wilhelm¹,

Klüter²,

Klouche³

et al. 1995

Vox Sanguinis

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There has been some discussion whether the atopic disposition of a blood donor is associated with a potentially higher incidence of hypersensitivity nonhemolytic transfusion reactions (NHTRs). Serum samples from patients who had suffered from NHTRs and samples from the platelet concentrates (PCs) responsible for the reactions were examined for total and specific IgE as diagnostic markers for allergic events. In addition, the allergy prevalence among 1,088 blood donors was determined to analyze the allergy prevalence among our blood donors. Our results indicate that in 90% of cases, allergic NHTRs were associated with specific IgE antibodies in the recipient’s serum, indicating the allergic disposition of the patient. In contrast, specific IgE antibodies were detected in only 22% in the transfused PCs. However, among all investigated NHTRs, there was not a single case in which specific IgE antibodies were detected exclusively in the PC. The allergy prevalence among our blood donors was about 26%. In our opinion, the few cases in which the allergic disposition of blood donors in combination with the allergic disposition of the recipients was associated with NHTRs reflects the allergy prevalence among our blood donors in general (26%). On the basis of these findings, we conclude that allergy diagnosis for blood donors is only of minor value in the prevention and prediction of NHTRs, whereas allergy diagnosis for patients who require multiple PC transfusion might be helpful.

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“…Payne and Rolfs [18] found white cell antibodies in the sera of 67% of patients who had febrile transfusion reactions, and suggested that the true incidence might be higher. At the other extreme, André, Dreyfus and Salmon [1] observed white cell and/or platelet anti bodies in only 31% of a series of samples from patients with febrile reactions; and Kevy, Schmidt, McGinnis and Workman [14] re ported that they were unable to demonstrate 'any correlation be tween the presence of leukoagglutinins and the occurrence of trans fusion reactions'.…”

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confidence: 99%

“…It is generally accepted that transfusion of white blood cells can induce nonhemolytic febrile transfusion reactions in patients with leukocyte agglutinins [1,5,8,9,11,12,13,14,15,18,21,24), but the frequency with which such clinical responses are due to white cell antibodies has been the subject of marked differences of opinion. Payne and Rolfs [18] found white cell antibodies in the sera of 67% of patients who had febrile transfusion reactions, and suggested that the true incidence might be higher.…”

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confidence: 99%