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Related Experiment Videos

Pre-transfusion testing problems caused by anti-lymphocyte globulin and their solution.

S K Ballas, E K Draper, C M Dignam

    Transfusion
    |May 1, 1985
    PubMed
    Summary

    Equine anti-lymphocyte globulin (ALG) in renal transplant patients can cause false-positive antiglobulin tests. Specific serologic techniques help differentiate this ALG panagglutinin from true alloantibodies.

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    Area of Science:

    • Transplantation immunology
    • Serology
    • Blood banking

    Background:

    • Anti-lymphocyte globulin (ALG) is crucial for managing T-cells in renal transplant recipients.
    • Administration of equine ALG has been associated with serologic interferences in patient blood testing.

    Purpose of the Study:

    • To investigate and characterize the serologic problems encountered in patients treated with equine ALG.
    • To identify methods for distinguishing ALG-induced panagglutinin from clinically significant alloantibodies.

    Main Methods:

    • Analysis of direct and indirect antiglobulin tests in 39 renal transplant patients receiving equine ALG.
    • Testing red blood cells (RBCs) with polyspecific and monospecific anti-human globulin sera.
    • Preparation and testing of eluates from patient RBCs.

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  • Evaluation of the hexadimethrine bromide (Polybrene) technique and neutralization by anti-human globulin.

    • Main Results:

    • Thirty-nine patients exhibited positive direct and indirect antiglobulin tests post-equine ALG administration.
    • Patient sera and RBC eluates demonstrated panagglutinin reactivity against all tested RBCs.
    • The ALG panagglutinin did not react with the Polybrene technique but was neutralized by anti-human globulin.

    Conclusions:

    • Equine ALG can induce a panagglutinin that mimics alloantibodies in antiglobulin tests.
    • The Polybrene technique and anti-human globulin neutralization are valuable tools for differentiating ALG panagglutinin from co-existing alloantibodies in transplant patients.