Four crossmatch methods to select platelet donors

Kakaiya, Ram; Gudino,; Miller, William V.; Sherman, Laurence A.; Katz, Amiram; Wakem, Christopher J.; Krugman, D. J.; Klatsky, Alan U.; Kiraly, Thomas

doi:10.1046/j.1537-2995.1984.24184122559.x

Cited by 37 publications

(24 citation statements)

References 28 publications

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“…Several studies [ 16,[18][19][20][21]271, including our own, have used CCI to measure platelet survival. Predicted count increment [23] and radiolabeled transfused platelets [ 171 have also been used to predict platelet survival.…”

Section: Discussionmentioning

confidence: 99%

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Predictive value of enzyme‐linked immunoassay platelet crossmatching for transfusion of platelet concentrates to alloimmunized recipients

Brubaker

Duke

Romine³

1987

American J Hematol

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Some evidence has shown that platelet crossmatching is useful in multitransfused patients with hypoplastic bone marrows who are refractory to platelet therapy through alloimmunization. Several immunoglobulin binding assays other than enzyme-linked immunospecific assay (ELISA) have been studied previously. We performed 51 ELISA crossmatches on six patients receiving single donor platelets. One bone marrow transplant patient receiving 33 single donor HLA matched (related and unrelated) was also studied. Effectiveness of transfusion was closely monitored by patient evaluation and corrected platelet count increment (CCI) at 1-2 and 18-24 hours posttransfusion. We found the ELISA method very sensitive, specific, and predictive, 85, 96, and 95.6% respectively in the 51 crossmatches studied in six patients with either leukemia, solid tumors, or aplastic anemia. However, variation existed among individual recipients, with sensitivity ranging from 70-100%. The distribution of true positives and negatives and false positives and negatives in the 33 crossmatches performed in the bone marrow transplant patient differed significantly (chi 2 = 101.2; P less than 0.001) from single donor recipients. The specificity in the 51 crossmatches on the six patients was also significantly different from the 33 crossmatches performed in the bone marrow transplant (96 vs 74%). This suggests individual variation occurs as well as differences in diseases and bone marrow suppressive agents affecting platelet crossmatching.

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Section: Discussionmentioning

confidence: 99%

“…should be reported. Freedman et al [18] included in their results a patient who had autoimmune thrombocytopenia purpura; Kakaiya et a1 [20] and Kickler et a1 [27] include multiple myeloma patients. Both diseases cause decreased survival of transfused platelets and may give negative crossmatch results, especially the dysproteinemias [28].…”

Section: Discussionmentioning

confidence: 99%

Predictive value of enzyme‐linked immunoassay platelet crossmatching for transfusion of platelet concentrates to alloimmunized recipients

Brubaker

Duke

Romine³

1987

American J Hematol

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“…Can serology help reduce HLA sensitization? The diagnostic tools used in patients under platelet support also vary considerably [20,21]. Continuously increasing platelet demand may necessitate a review of the diagnostic tools used to detect antibodies pertinent to platelet transfusion.…”

Section: Discussionmentioning

confidence: 99%

Serological Screening, Using Three Different Test Systems of Platelet-Transfused Patients with Hematologic-Oncologic Disorders

Wernet¹,

Schnaidt²,

Mayer³

et al. 1993

Vox Sanguinis

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Sera of hematologic-oncologic patients were tested regularly after platelet transfusions in three test systems: lymphocytotoxicity test, platelet adhesion immunofluorescence test, and - only selected sera - in the monoclonal antibody-specific immobilization of platelet antigen test. Of 388 patients 53 (14%) had HLA antibodies 5 of these in combination with platelet-specific alloanti- bodies. Lymphocyte-restricted (non-HLA) reactions were observed in 20 patients, the majority of which was attributed to lymphocyte-specific auto- or alloantibodies. Sera of 27 patients showed platelet-specific reactions, usually cold-reacting autoantibodies which have no effect in vivo.

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“…The PAlFT is a modification of the method described by von dcm Borne et al (25), which we reported previously (2). Briefly, the concentration of washed platelets was adjusted to 1 X 107/ml and .05 ml of the suspension was placed on a glass slide precoated with 0.1 % poly-Llysine to facilitate platelet adhesion.…”

Section: Platelet Adhesion Lmmunofluorescent Test (Paiftimentioning

confidence: 99%

Retrospective evaluation of flow cytometry as a platelet crossmatching procedure

Gates

MacPherson

1994

Cytometry

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We performed a retrospective analysis of flow cytometry as a platelet crossmatching procedure. Sera from 17 alloimmunized refractory patients were tested against 32 donor platelets, which had been stored as platelet-rich plasma for up to 36 months. Overall, 14/32 (44%) crossmatches were positive. The mean 1 h posttransfusion corrected count increments (CCls) were 9,195 and 2,269 for a negative and a positive crossmatch, respectively. The predictive value of a positive crossmatch was 86%, whereas the predictive value of a negative crossmatch was 56%. When samples with low background fluorescence or with high panel-reactive antibody (PRA) levels were evaluated separately, the accuracy of the crossmatch improved from 69% to 80%. When compared to the platelet adhesion immunofluorescence test (PAIFT) and the standard and antiglobulin-enhanced lymphocytotoxicity tests for the detection of HLA antibodies, flow cytometry appeared to be more sensitive. We conclude that flow cytometry is a useful technique for platelet crossmatching, particularly for alloimmunized patients for whom HLA compatible platelets may not be readily available. o 1994 Wiley-Liss, Inc. Key terms: Blood platelets, platelet transfusions, platelet antibody testingThe management of platelet recipients who are refractory to random donor platelet concentrates poses a difficult problem. Many, but not all of these patients are alloimmunized to HLA-A and -B antigens, platelet-specific antigens, or both. Standard practice is to provide these patients with single donor platelets that are partially or completely matched with the recipient's HLA-A and -B antigens (15,19,24). Although HLA-compatible (A an B-U match grade) platelets are preferred, the marked polymorphism of the HLA system limits their availability. Accordingly, most recipients must be supported with single donor platelets that are mismatched for one or more of the recipient's HLA antigens (6).Recently, platelet crossmatching has been proposed as an alternative to HLA-based donor selection ( 3,4,7,10, 1 1,23). The advantages of platelet crossmatching are that antibodies directed against platelet-specific as well as HLA antigens can be detected and the need for a large pool of H1.A typed donors is avoided. We have developed a flow cytometric procedure for platelet antibody detection (27). In this study, we performed a retrospective evaluation of this method as a platelet crossmatching technique. MATERIALS AND METHODS SubjectsThe 17 patients in this study were participants in a multicenter investigation comparing the efficacy of pro-C 1994 Wiley-Liss, Inc.spective platelet crossmatching and HLA-based selection, the results of which were reported previously (21). These patients were refractory to random donor platelet concentrates (posttransfusion corrected platelet count increments at 1 h less than 7,500 on two consecutive occasions) and lacked nonimmune factors associated with refractoriness, the majority of these patients were either bone marrow transplant recipients or patients with acute leukemi...

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Four crossmatch methods to select platelet donors

Cited by 37 publications

References 28 publications

Predictive value of enzyme‐linked immunoassay platelet crossmatching for transfusion of platelet concentrates to alloimmunized recipients

Predictive value of enzyme‐linked immunoassay platelet crossmatching for transfusion of platelet concentrates to alloimmunized recipients

Serological Screening, Using Three Different Test Systems of Platelet-Transfused Patients with Hematologic-Oncologic Disorders

Retrospective evaluation of flow cytometry as a platelet crossmatching procedure

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