The use of a potential novel tool in virtual crossmatching for platelet transfusion in platelet refractoriness.
Vox Sang
; 110(1): 70-8, 2016 Jan.
Article
em En
| MEDLINE
| ID: mdl-26274830
BACKGROUND AND OBJECTIVES: Transfusion support for immune-mediated platelet refractoriness (PR) is clinically challenging, technically laborious and costly. The development of 'EpHLA/EpVix software' has been used successfully to select kidney donors. Here, we sought to evaluate this new software as a tool for platelet virtual crossmatch (VxM). MATERIALS AND METHODS: This is a prospective study from 2007 to 2014 of PR patients in a tertiary hospital. Platelet components selected by HLAMatchmaker program were crossmatched by EpHLA/EpVix, anti-human globulin complement-dependent lymphocytotoxicity test (AHG-CDC), flow cytometry platelet crossmatch (FCxM) and then compared. Effectiveness of platelet components transfused was evaluated by CCI. RESULTS: Ninety-seven crossmatched platelet transfusions for 27 patients were enrolled. Partial matches were analysed for 75 transfusions by the 3 methods, and 22% showed discrepant results among the assays. After further analysis, data showed that all divergent cases could be explained by HPA alloimmunization, prozone effect (FCxM), low sensitivity of AHG-CDC and possible interference in FCxM/AHG-CDC assays. Notably, sensitivity and specificity of VxM analysis was excellent (100%). Satisfactory CCI counts were obtained for the majority (22/30) of the transfusions. CONCLUSION: The new EpHLA/EpVix method showed to be effective, feasible and fast for VxM at no cost and able to minimize labour on donor identification. However, platelet crossmatching may be a necessary step because EpHLA/EpVix does not formally exclude HPA alloimmunization.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Software
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Tipagem e Reações Cruzadas Sanguíneas
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Teste de Histocompatibilidade
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Transfusão de Plaquetas
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Seleção do Doador
Tipo de estudo:
Diagnostic_studies
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Evaluation_studies
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Observational_studies
Limite:
Adolescent
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Adult
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Aged
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Child, preschool
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Female
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Humans
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Infant
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Middle aged
Idioma:
En
Revista:
Vox Sang
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
Reino Unido