title: The importance of ABH antigens in platelet crossmatching.
abstract: In the present study, the frequency with which ABH incompatibility could be detected in platelet crossmatches was determined. The effect of chloroquine elution on ABH antigens was also evaluated, and a technique was developed to remove IgG anti-A from group O plasma using a chemically synthesized human blood group A trisaccharide antigen covalently linked to crystalline silica (Synsorb-A). Group O plasmas were found to be incompatible with 52 percent of group A platelets and 17 percent of group B platelets (p less than 0.05). In contrast, anti-A from group B plasmas rarely produced a positive crossmatch, and no anti-B that reacted with platelets could be demonstrated in group A plasmas. IgG anti-A reactions with group A platelets were eliminated in 100 percent of the group O plasmas tested after treatment with the synthetic solid-phase immunoadsorption technique. Synsorb-A may be a useful adjunct to platelet serologic testing when group O sera need to be tested against A platelets. Group A platelets bound less anti-A after exposure to chloroquine, but only 17 percent of platelets became negative when crossmatched with group O plasma. It was concluded that increased IgG binding occurs in a majority of platelet crossmatches using a k-ELISA technique when group O recipients are tested against group A donors. These results offer a potential explanation for conflicting results in studies of transfusion results with ABH-incompatible platelets. Transfusions of group B platelets to incompatible recipients may be more likely to yield satisfactory increments than incompatible transfusions of group A platelets, but this remains to be proven. There appear to be significant differences between red cells and platelets in regard to serologic reactivity in the ABH system.
authors.affiliation: American Red Cross, Rochester Region, NY.
authors.forename: J M
authors.initials: JM
authors.lastname: Heal
authors.forename: A
authors.initials: A
authors.lastname: Mullin
authors.forename: N
authors.initials: N
authors.lastname: Blumberg
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000327:Adsorption; D000911:Antibodies, Monoclonal; D000937:Antigen-Antibody Reactions; D000961:Antilymphocyte Serum; D001787:Blood Group Incompatibility / Q000175:diagnosis; D001788:Blood Grouping and Crossmatching / Q000379:methods; D001792:Blood Platelets / Q000276:immunology*; D002738:Chloroquine; D006801:Humans; D007106:Immune Sera; D007074:Immunoglobulin G / Q000378:metabolism
chemical_list: D000017:ABO Blood-Group System; D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D007106:Immune Sera; D007074:Immunoglobulin G; D002738:Chloroquine