Abstract. Within the last two years, 12 examples of red cell antibody with apparent anti‐N specificity have been found in the sera of 416 prospective kidney transplant recipients maintained on chronic hemodialysis. Eight of the 12 patients were N‐positive, three of them in the homozygous state. Serial samples from these patients were tested against M, MN and N cells of compatible ABO types, and in 10 of the 12 cases against the patients' own red cells. Anti‐N‐like antibody was detected only after many months of chronic hemodialysis, and it decreased or disappeared after transplantation. Its appearance was not related to blood transfusion. The ability of the antibody to agglutinate patients' own red cells in the cold explains the loss of several cooled renal allografts.
Within the last two years, 12 examples of red cell antibody with apparent anti- N specificity have been found in the sera of 416 prospective kidney transplant recipients maintained on chronic hemodialysis. Eight of the 12 patients were N-positive, three of them in the homozygous state. Serial samples from these patients were tested against M, MN and N cells of compatible ABO types, and in 10 of the 12 cases against the patients’ own red cells. Anti-N-like antibody was detected only after many months of chronic hemodialysis, and it decreased or disappeared after transplantation. Its appearance was not related to blood transfusion. The ability of the antibody to agglutinate patients’ own red cells in the cold explains the loss of several cooled renal allografts.
For the past four years, the method presented here for the detection of leukoagglutinins has been successfully integrated into the routine procedures of a community blood bank. Patients' sera are tested against leukocytes from 12 Group O donors. White cell suspensions are prepared from defibrinated blood using 4 per cent polyvinylpyrrolidone (PVP) as a sedimenting agent. Tests have been performed on 276 patients, among whom 89 (32 per cent of the total) were found to possess leukoagglutinins. Of the 89 individuals in whose sera leukoagglutinins were demonstrated, 85 had a reported history of febrile transfusion reactions, frequently accompanied by chills, occasionally with urticaria. These 85 patients made up 57 per cent of 150 cases who had been reported as experiencing nonhemolytic febrile reactions shown by several workers to occur in patients with leukoagglutinins. Also described are methods used for the preparation of leukocyte‐poor units requested for patients whose sera have been shown to contain leukoagglutinins.
Red blood cell recovery was better and removal of white cells equally good when units were centrifuged briefly in an upright position as compared to more prolonged centrifugation in an inverted position. Nylon fiber filtration left more white cells than did differential centrifugation; a combination of the two technics provided the smallest amount of white cell contamination. Red blood cells frozen and deglycerolized by the original Huggins process had as many leukocytes as those prepared by differential centrifugation. The current Huggins process left more white cells than did the original method.Removal of white cells from blood frozen and deglycerolized by the Huggins process was better in a continuous flow centrifuge than in the Cytoglomerator. Platelet removal was less complete than that of white cells by either technic. Preliminary results with CPD blood do not appear significantly different from those with ACD blood.
The Aster complement fixation test for the detection and identification of platelet isoantibodies was modified for use in microtiter plates. Results with both methods were identical. The technic presented here has a number of advantages: smaller volumes of reagents are required, more dilutions of sera can be tested with less expenditure of time, and comparison of results with different sera is easier to evaluate.
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