Analysis of a high‐throughput HLA antibody screening assay for use with platelet donors

Abstract

Background-Passive infusion of HLA antibodies has been implicated in transfusion reactions. A rapid, inexpensive method of screening blood donors for HLA antibodies might reduce the incidence of reactions. A high-throughput microbead-flow analyzer HLA antibody detection technique was compared with an ELISA method.

The effect of previous pregnancy and transfusion on HLA alloimmunization in blood donors: implications for a transfusion‐related acute lung injury risk reduction strategy

“…The Luminex assay was also used in two recent smaller studies of HLA alloimmunization in blood donors, both of which reported higher rates than what we observed at the 3SD cutoff but similar to our results at the NBG cutoff of 2.2 10,26. Powers et al tested 1027 women and 26 males with a history of transfusion.…”

“…These ELISA results are almost identical to the results of a larger study of 1043 donors reporting HLA antibodies in 9.8% of females and none in males 27. The most likely explanation for the high prevalence using microbead flow assays observed in the two smaller studies10,26 is that they used the manufacturer's suggested NBG cutoff of 2.2. We found similar results in our larger study when we used the same cutoffs.…”

“…They identified HLA antibodies in 25.4% of all female donors (vs. 17.3% at 3SD and 27.4% at NBG 2.2 in our study), 5.9% in never pregnant nor transfused women (vs. 1.7% at 3SD and 8.3% at NBG 2.2 in our study), and 12.0% of non-transfused males (vs. 1.0% at 3SD and 6.8% at NBG 2.2 in our study). A smaller study by Fadeyi et al26 also reported a higher prevalence of HLA antibodies in 96 apheresis donors; finding HLA antibodies in 56% of females and 35% of males. Fadeyi et al26 also tested each sample for HLA antibodies by ELISA and reported that 5/44 (9%) of women and 0/55 (0%) men were positive.…”

“…A smaller study by Fadeyi et al26 also reported a higher prevalence of HLA antibodies in 96 apheresis donors; finding HLA antibodies in 56% of females and 35% of males. Fadeyi et al26 also tested each sample for HLA antibodies by ELISA and reported that 5/44 (9%) of women and 0/55 (0%) men were positive. These ELISA results are almost identical to the results of a larger study of 1043 donors reporting HLA antibodies in 9.8% of females and none in males 27.…”

Low-level HLA antibodies do not predict platelet transfusion failure in TRAP study participants

“…[20][21][22][23] These systems are generally more sensitive than LCA, and several commercial kits are currently available. 20,[24][25][26] Antibodies against human platelet antigens (HPAs) can also be generated in response to platelet transfusion. These antigens appear to be less immunogenic than HLA antigens, resulting in a lower frequency of HPA alloimmunization, which ranges from 0% to 2%, depending on the patient population.…”