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Published on: May 5, 2017
Flow cytometric analysis in platelet crossmatching using a platelet suspension immunofluorescence test
B Skogen1, D Christiansen, A Husebekk
1Department of Immunology and Transfusion Medicine, University Hospital of Tromsø, Norway.
Insights
Flow cytometry effectively measures platelet antibodies for crossmatching, offering accurate predictions for transfusion success. This automated method provides sensitivity comparable to existing techniques for alloimmunized patients.
Area of Science:
- Immunology
- Transfusion Medicine
- Flow Cytometry
Background:
- Platelet antibody detection is crucial for successful transfusions in alloimmunized patients.
- Traditional crossmatch techniques have limitations in sensitivity and automation.
Purpose of the Study:
- To investigate the sensitivity of flow cytometric measurement of platelet antibodies in a crossmatch technique.
- To compare flow cytometry's fluorescence ratio with corrected count increment post-transfusion.
Main Methods:
- Flow cytometry was used to determine the fluorescence ratio in platelet crossmatching.
- Corrected count increment after platelet transfusion was used as a measure of transfusion success.
Main Results:
- A fluorescence ratio <= 1.7 predicted satisfactory transfusion responses (corrected count increment > 7.5) with high predictive values (94% negative, 87% positive).
- Platelets stored for up to 4 weeks showed minimal loss of HLA class I and HPA-1a, but a slight continuous loss of HPA-3a.
Conclusions:
- Flow cytometry is a sensitive and reliable method for platelet crossmatching.
- The automated platelet suspension immunofluorescence test offers advantages in sensitivity and predictive value for transfusion outcomes.
Background:
The sensitivity of flow cytometric measurement of platelet antibodies in a crossmatch technique was investigated.
Study Design And Methods:
The corrected count increment after platelet transfusion was compared with the fluorescence ratio determined by flow cytometric measurement.
Results:
When crossmatching was performed before transfusion(s) in alloimmunized patients, a fluorescence ratio < or = 1.7 was associated with satisfactory responses (corrected count increment > or = 7.5), and the predictive values for negative and positive crossmatch results were 94 and 87 percent, respectively. Analysis of antigen preservation during platelet storage with antibodies to HLA alpha-chain, HLA-B27, HPA-1a, and HPA-3a showed that platelets can be stored, refrigerated, for up to 4 weeks without significant loss of HLA class I and HPA-1a. There was a slight but continuous loss of HPA-3a upon storage.
Conclusion:
Flow cytometric measurement of fluorescence in the platelet suspension immunofluorescence test can be used for platelet crossmatching, with sensitivity and predictive values comparable to those of previously described techniques and with the advantage of automation.
