Platelet transfusion therapy. Optimal donor selection with a combination of lymphocytotoxicity and platelet fluorescence tests

Brand, Anneke; Leeuwen, A. van; Eernisse, J. G.; Rood, JJ van

doi:10.1182/blood.v51.5.781.781

Cited by 142 publications

(62 citation statements)

References 12 publications

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“…In all these investigations the presence of HLA antibodies was determined by the reactivity of sera against leucocyte antigens inferring their reactivity against platelets. The need to test for HLA antibodies, reactive with platelets rather than with lymphocytes, has been emphasized previously (Brand et al, 1978). We therefore used the MAIPA technique in all our patients to specifically determine the serum reactivity against human 2 -microglobulins associated with HLA class I molecules on platelets.…”

Section: Discussionmentioning

confidence: 99%

Specificities of anti‐platelet antibodies in multitransfused patients with haemato‐oncological disorders

Kurz¹,

Greinix

Höcker³

et al. 1996

Br J Haematol

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The clinical condition and the formation of platelet-reactive antibodies influence the post-transfusion platelet increment. We analysed the specificities of platelet-reactive antibodies in 81 multitransfused patients with haemato-oncological diseases refractory to platelet transfusions, or prior to a scheduled stem cell transplantation. In 17 additional patients we prospectively determined the development of platelet-reactive antibodies at the time of chemotherapy in weekly intervals. Sera were tested by the monoclonal antibody-specific immobilization of platelet antigens (MAIPA)-technique for antiplatelet antibodies against HLA class I antigens, the human platelet-specific alloantigens (HPA)-1, -2, -3, -5, and the platelet membrane glycoproteins (GP) Ia/IIa, Ib/IX, IIb/IIIa (panreactive). Platelet reactive antibodies were found in 54% of blood samples. They were frequent in patients with a history of possible previous immunization, particularly if patients were refractory to platelet transfusions. Platelet-reactive HLA antibodies were the most common antibodies. Even patients without a known risk of primary immunization who received exclusively leucocyte-depleted blood products formed antibodies. By the MAIPA technique, even LCT-negative sera were found to contain platelet-reactive antibodies.

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Section: Discussionmentioning

confidence: 99%

Specificities of anti‐platelet antibodies in multitransfused patients with haemato‐oncological disorders

Kurz¹,

Greinix

Höcker³

et al. 1996

Br J Haematol

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“…Other investigators have reported studies of platelet crossmatch tests using various methods to measure platelet associated IgG. These techniques have included immunofluorescence (Brand et al, 1978;Myers et al, 1981a, b;Waters et al, 1981;Pegels et al, 1982), radiolabelled anti-IgG (Kickler et al, 1983;Mueller-Eckhardt et al, 1980) and peroxidaseanti-peroxidase (Schmidt et al, 1980;Hecht et al, 1982). For example , Brand et al(1978), using a combination of lymphocytotoxicity and fluorescent platelet antibody crossmatch techniques, reported a 93% success rate in predicting platelet transfusion compatiblity.…”

Section: Discussionmentioning

confidence: 99%

Platelet crossmatch tests using radiolabelled staphylococcal protein A or peroxidase anti-peroxidase in alloimmunized patients

Yam¹,

Petz²,

Scott³

et al. 1984

Br J Haematol

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Refractoriness to random-donor platelets as a result of alloimmunization remains a major problem in long-term platelet transfusion therapy despite the use of HLA-matched platelets. We have therefore studied the use of two methods for detection of platelet associated IgG as platelet crossmatch tests for the selection of platelet donors. These methods use radiolabelled staphylococcal protein A ( 1251-SPA) and peroxidase anti-peroxidase (PAP), respectively.One hundred and ten crossmatch tests using I2%SPA were performed retrospectively in 18 alloimmunized patients. The results indicated that the predictive value of a positive or a negative test was 8 7%; the sensitivity was 73% and the specificity was 95%. Results with the PAP test were similar. The HLA types were known for 48 donor-recipient pairs. With few exceptions, there was a correlation between the results of the platelet crossmatch tests and the effectiveness of platelet transfusion regardless of the degree of HLA match. These results indicate that platelet crossmatch tests may be valuable even when closely HLA matched donors are not available. A large-scale prospective study is warranted, particularly in highly immunized patients. Alloimmunization and the resultant refractoriness to random donor platelet transfusions occur in patients who receive repeated transfusions of platelets from random donors. Estimates of the frequency of alloimmunization range from about 35% to 100% (Dutcher et al, 1981; Klein & Blajchman, 1982). Alloimmunized patients frequently respond to platelet transfusions from donors matched for HLA-A and -B antigens (Yankee et al, 1969, 1973; Lohnnann et al, 19 74) or serologically crossreactive antigens (Svejgaard & Kissmeyer-Nielsen, 1968; Mittal & Terasaki, 1974; Duquesnoy et al, 1977a; Tomasulo, 1978).

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“…This will usually restore satisfactory platelet increments. Platelet cross-matching tests may help at this stage to predict compatible donors (Brand et al, 1978;Gmiir et al, 1978), or they may be introduced when an HLA matched donor fails to produce satisfactory increments. The logistics of finding a compatible donor under the latter circumstances remains to be established by prospective studies.…”

Section: Discussionmentioning

confidence: 99%

“…This has led to the assessment of a number of different cross-matching techniques using the donor's platelets (Aster, 1978). The most promising results have been reported by Brand et al(1978), using an indirect fluorescent antiglobulin technique in conjunction with lymphocytotoxicity (LCT) cross-matching. This enabled them to predict platelet incompatibility in the face of apparent HLA compatibility.…”

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confidence: 99%

“…The special advantage of the PIFT is that it will detect platelet-specific antibodies as well as HLA antibodies active against platelets. As in the study of Brand et al(1978), the PIFT has been used in conjunction with the LCT. In addition, an indirect lymphocyte immunofluorescence test (LIFT) has been included to demonstrate HLA antibodies not detected by the LCT (DCcary et al, 1975).…”

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confidence: 99%

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A Cross‐matching Procedure for the Selection of Platelet Donors for Alloimmunized Patients

et al. 1981

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Summary. A platelet cross‐matching procedure has been assessed for selecting compatible donors for alloimmunized patients. This confirms the clinical value of combining an indirect platelet immunofluorescence test (PIFT) with a lymphocyto toxicity test (LCT) in predicting the survival of single‐donor platelets. There was good agreement between the PIFT cross‐match and post‐transfusion platelet recovery. Compatibility in the LCT alone was insufficient for platelet donor selection, as this test did not detect all antibodies affecting platelet survival. Positive LCT and PIFT cross‐matches indicated the presence of HLA antibodies. Inclusion of an indirect lymphocyte immunofluorescence test (LIFT) helped to classify the platelet antibody when the LCT cross‐match was negative. In such cases, parallel positive findings with the LIFT and PIFT suggested a cytotoxic‐negative antibody of probable HLA specificity active against platelets. Disparity between the LIFT and PIFT was also observed; a strongly positive PIFT along with a weak reaction in the LIFT suggested that a platelet‐specific antibody was responsible for the poor platelet survival in these cases. This study has also shown the presence in multitransfused patients of LIFT‐positive antibodies not reacting in the LCT and PIFT, which do not affect the survival of transfused platelets. A positive granulocyte cross‐match was demonstrated in patients with febrile rigors associated with compatible platelet transfusions. Splenectomy and steroids may improve the survival of incompatible platelets depending on the nature of the platelet antibody.

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Platelet transfusion therapy. Optimal donor selection with a combination of lymphocytotoxicity and platelet fluorescence tests

Cited by 142 publications

References 12 publications

Specificities of anti‐platelet antibodies in multitransfused patients with haemato‐oncological disorders

Specificities of anti‐platelet antibodies in multitransfused patients with haemato‐oncological disorders

Platelet crossmatch tests using radiolabelled staphylococcal protein A or peroxidase anti-peroxidase in alloimmunized patients

A Cross‐matching Procedure for the Selection of Platelet Donors for Alloimmunized Patients

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