Increased detection of clinically significant antibodies and decreased incidence of delayed haemolytic transfusion reaction with the indirect antiglobulin test potentiated by polyethylene glycol compared to albumin: a Japanese study.
BACKGROUND
The indirect antiglobulin test (IAT) can be potentiated by agents such as polyethylene glycol (PEG-IAT) and albumin (Alb-IAT). PEG-IAT is generally regarded as superior to Alb-IAT for the detection of clinically significant red blood cell (RBC) antibodies. However, supporting data come from Caucasian-dominant populations. Non-Caucasian populations should be investigated as well.


METHODS
In this single-centre, retrospective, sequential study, Alb-IAT was used from 1989 to 1996 (8 years) and PEG-IAT from 1997 to 2008 (12 years). Pre-transfusion RBC alloantibody detection rates and specificity, post-transfusion alloantibody production, and the incidence of delayed haemolytic transfusion reaction were assessed and compared for the two periods.


RESULTS
Although overall RBC alloantibody detection rates were comparable, PEG-IAT more frequently detected clinically significant antibodies such as anti-E, anti-Fy(b), and anti-Jk(a), and less frequently detected insignificant antibodies such as anti-Le(b) and anti-P(1). New alloantibodies emerged comparably during the two periods. Delayed haemolytic transfusion reaction was less frequent during the PEG-IAT period (0.30% versus 0.12%, p<0.05).


CONCLUSIONS
PEG-IAT was superior in the detection of clinically significant antibodies, reduced the detection of insignificant antibodies, and prevented delayed haemolytic transfusion reaction better than Alb-IAT among Japanese transfusion recipients in this retrospective survey of limited power.
Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University Hospital, Hikariga-oka, Fukushima City, Japan.
Miho
M
Okutsu
Hitoshi
H
Ohto
Hiroyasu
H
Yasuda
Kinuyo
K
Kawabata
Satoshi
S
Ono
Shunnichi
S
Saito
Akiko
A
Sugawara
Masami
M
Kikuchi
Saori
S
Miura
Youko
Y
Ishii
Kazuya
K
Watanabe
Yuriko
Y
Tohyama
Kenneth E
KE
Nollet
D000418:Albumins / Q000737:chemistry; D044466:Asian People; D001789:Blood Group Antigens; D001787:Blood Group Incompatibility / Q000453:epidemiology* / Q000517:prevention & control; D003298:Coombs Test / Q000379:methods* / Q000592:standards; D005260:Female; D006461:Hemolysis; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000737:chemistry*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D065227:Transfusion Reaction
D000418:Albumins; D001789:Blood Group Antigens; D007518:Isoantibodies; D011092:Polyethylene Glycols
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