Evaluation of four methods for platelet compatibility testing.
Four platelet compatibility assays were performed on serum and platelet or lymphocyte samples from 38 closely HLA-matched donor/recipient pairs involved in 55 single-donor platelet transfusions. The 22 patients studied were refractory to transfusions of pooled random-donor platelets. Of the four assays (platelet suspension immunofluorescence, PSIFT; 51Cr release; microlymphocytotoxicity; and a monoclonal anti-IgG assay, MAIA), the MAIA was most predictive of platelet transfusion outcome (predictability, 74% for one-hour posttransfusion platelet recovery and 76% for 24-hour recovery). The only other assay to reach statistical significance was the PSIFT (63% predictability for one-hour posttransfusion recovery). The degree of HLA compatibility between donor and recipient (exact matches v those utilizing cross-reactive associations) was unrelated to the ability of the MAIA to predict transfusion results. The MAIA may be capable of differentiating HLA antibodies, ABO antibodies, and platelet-specific antibodies responsible for failure of HLA-matched and selectively mismatched single-donor platelet transfusions.
D000911:Antibodies, Monoclonal; D001782:Blood Donors; D001792:Blood Platelets / Q000276:immunology; D002470:Cell Survival; D002860:Chromium Radioisotopes / Q000378:metabolism; D003429:Cross Reactions; D003601:Cytotoxicity Tests, Immunologic / Q000379:methods; D005069:Evaluation Studies as Topic; D005455:Fluorescent Antibody Technique; D006680:HLA Antigens / Q000032:analysis*; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D017713:Platelet Transfusion
D000911:Antibodies, Monoclonal; D002860:Chromium Radioisotopes; D006680:HLA Antigens