Platelet alloimmunization after transfusion. A prospective study in 117 heart surgery patients.
OBJECTIVE
The frequency of platelet-specific antibodies after one series of blood transfusions has not been reported, and in multiply transfused patients is controversial.


METHODS
We studied the frequency of alloimmunization against platelet antigens in 117 patients who received a single series of blood transfusions. They received mostly saline-adenine-glucose+mannitol red blood cell components (poor in leukocytes and platelets) in connection with cardiac surgery. Platelet-specific antibodies were detected with the platelet ELISA and the monoclonal-antibody-specific immobilization of platelet antigen assay. HLA antibodies were detected by the standard lymphocyte cytotoxicity techniques.


RESULTS
We found platelet-specific anti-HPA-5b (anti-Bra) in 2 cases (1.7%). One antibody was the result of de novo immunization. We detected lymphocytotoxic HLA antibodies in 21 patients (17.9%), of whom 18 (15.4%) had had no detectable antibodies before transfusion. There was a positive correlation between the transfused load of immunogenic materials and the frequency of alloimmunization against HLA antigens. In one third of the immunized patients, there was no history of previous immunization.


CONCLUSIONS
There was a low incidence of platelet-specific antibodies after one series of blood transfusions in this group of patients. This is similar to the results of some previous studies in multiply transfused patients, but not with those of others who found a higher incidence.
Taaning
E
E
Department of Clinical Immunology and Blood Bank, Glostrup Hospital, Denmark.
Simonsen
A C
AC
Hjelms
E
E
Svejgaard
A
A
Morling
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000918:Antibody Specificity; D016824:Antigens, Human Platelet / Q000276:immunology*; D016913:Blood Component Transfusion / Q000009:adverse effects; D001792:Blood Platelets / Q000276:immunology*; D006348:Cardiac Surgical Procedures; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007114:Immunization; D015994:Incidence; D007518:Isoantibodies / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D010298:Parity; D010949:Plasma; D011446:Prospective Studies; D065227:Transfusion Reaction
D016824:Antigens, Human Platelet; D006680:HLA Antigens; D007518:Isoantibodies