SELECTION OF DONOR PLATELETS FOR ALLOIMMUNIZED PATIENTS USING A PLATELET-ASSOCIATED IGG ASSAY

  • 1 January 1981
    • journal article
    • research article
    • Vol. 58  (3) , 444-450
Abstract
A quantitative immunofluorescence platelet-associated immunoglobulin-G (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 51Cr-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 PA-IgG incompatible donor platelets were found. Survival 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; 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%); platelet aggregation, serotonin release and lymphocytotoxicity testing showed correct predictions for only 41-59% of the survival studies. PA-IgG testing predicted which HLA-A and B matched platelets had reduced survival times, thus indicating 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.