Selection of donor platelets for alloimmunized patients using a
platelet-associated IgG assay
TJ Myers, BK Kim, M Steiner and MG Baldini
A quantitative immunofluorescence platelet-associated immunoglobulins
(PA-IgG) assay was used to detect alloimmunity to platelets in 8/12
multitransfused patients and to perform platelet crossmatching in the 8
alloimmunized patients. The correct separation of multitransfused patients
into alloimmune and nonalloimmune groups was substantiated with
chromium-51-labeled platelet survival studies. For 5 alloimmunized
patients, compatible and incompatible donor platelets were demonstrated by
PA-IgG crossmatching and were confirmed by platelet survival studies. With
the other 3 alloimmunized patients, only studies with 5 of these
incompatible donor platelets showed markedly reduced survival times on 4
occasions. PA-Igg compatible donor platelets survived 3.5- 8.7 days, while
PA-IgG incompatible platelets showed survival times of 0.1-2.4 days.
Overall, PA-IgG testing correctly indicated survival results on 15/17
occasions (88%), whereas platelet aggregation, serotonin release, and
lymphocytotoxicity testing showed correct predictions for only 41%-59% of
the survival studies. PA-IgG testing predicted which times, thus indication
patients with platelet-specific alloantibodies. the PA-IgG assay provides a
sensitive method to detect platelet alloantibodies and to perform platelet
crossmatching, which can complement HLA typing in the selection of donor
platelets for alloimmunized patients.
Volume 58,
Issue 3,
pp. 444-450,
09/01/1981
Copyright © 1981 by The American Society of Hematology
