RANDOM DONOR PLATELET CROSSMATCHING - COMPARISON OF 4 PLATELET ANTIBODY DETECTION METHODS
RANDOM DONOR PLATELET CROSSMATCHING - COMPARISON OF 4 PLATELET ANTIBODY DETECTION METHODS
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DOI：
10.1002/ajh.2830280102
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发表时间：
1988-05-01
影响因子：
12.8
通讯作者：
BLANCHETTE, V
中科院分区：
文献类型：
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作者：
FREEDMAN, J;GARVEY, MB;BLANCHETTE, V
在前瞻性交叉配血中检查标准淋巴细胞毒性试验（LCT）、生物素-亲和素酶免疫测定（ELISA）、血小板悬液免疫荧光试验（PSIFT）和血小板放射性抗球蛋白试验（普拉），以选择相容的随机供体血小板用于难治性患者。在26例患者中评价了107次合并随机供体血小板输注。各技术的结果具有良好的重现性。不同方法的结果一致性为40- 60%。比较输血后1小时和24小时校正计数增量（CCI）作为评估输血成功或失败的参数。使用等级评分系统，所有输血的相对预测效率为普拉> LCT > PSIFT > ELISA。普拉和LCT的组合提供了最佳的可预测性，并且灵敏度高于普拉或LCT单独使用（分别为93 vs. 79和62%）。平均输血后CCI（×109/L）为13.9 . ±-。12.7在1小时和7.3 ±。6.9在24小时;在PRAT不相容的血小板之后，5.7 ±。7.8（1小时）和2.1 . ±. 4.1（24小时）。LCT检测的血小板结果相似。在选定的病例中开发和使用的普拉的放射性离子超滤修改是简单、快速、有效和廉价的。该研究表明，评价的技术是实用和可行的常规使用中提供兼容的随机供体血小板难治性患者谁没有其他原因增加血小板破坏。
The standard lymphocytotoxicity assay (LCT), a biotin-avidin enzyme immunoassay (ELISA), platelet suspension immunofluorescence test (PSIFT), and platelet radioactive antiglobulin test (PRAT) were examined in prospective crossmatching for selection of compatible random donor platelets for refractory patients. One hundred seven episodes of pooled random donor platelet transfusions were evaluated in 26 patients. There was good reproducibility of results by individual techniques. Concordance of results by the different methods was 40-60%. One-hour and 24 hr posttransfusion corrected count increments (CCI) were compared as parameters for assessing success or failure of the transfusion. Using a rank scoring system, the relative efficiency of predictiveness for all transfusion was PRAT > LCT > PSIFT > ELISA. Combination of PRAT and LCT afforded the best predictability and sensitivity was higher than for either PRAT or LCT alone (93 vs. 79 and 62%, respectively). Mean posttransfusion CCI (.times. 109/L) following PRAT-compatible platelets was 13.9 .+-. 12.7 at 1 hr and 7.3 .+-. 6.9 at 24 hr; following PRAT-incompatible platelets, 5.7 .+-. 7.8 (1 hr) and 2.1 .+-. 4.1 (24 hr). Results were similar for LCT-tested platelets. A radioiummnofiltration modification of the PRAT developed and used in selected cases was simple, fast, efficient, and inexpensive. The study indicated that the techniques evaluated are practical and feasible for routine use in the provision of compatible random donor platelets to the refractory patient who has no other cause for increased platelet destruction.