Analysis of cutoffs for screening sensitized blood donors for HLA alloantibodies using a cytometric microbead assay

Transfusion
Robert S MakarAmy Powers

Abstract

Cytometric-based microbead assays for HLA alloantibodies may be effective tools for transfusion-related acute lung injury (TRALI) risk reduction. However, the optimal cutoff for donor screening is unclear. To optimize the screening test cutoff in sensitized donors, sera were screened with a cytometric microbead assay. Confirmatory testing was performed on samples with a normalized background (NBG) ratio of 2.4 or more. Sera with a NBG of 2.4 to 9.9 had positive predictive values (PPVs) of 78.2% (95% confidence interval [CI], 67.8%-86.0%) and 71.1% (95% CI, 56.5%-82.4%) for Class I and II antibodies, respectively. Sera with a NBG of 10 or more had PPVs of 98.9% (95% CI, 93.3%-100%) and 99.1 (95% CIs, 94.7%-100%) for Class I and II, respectively. The percent panel-reactive antibody (PRA) of confirmed HLA alloantibodies from sera with a NBG of 2.4 to 9.9 was 29.3±17% (mean±standard deviation) for Class I and 22.3±16.7% for Class II, but for antibodies from sera with a NBG of 10 or more the PRAs were 65.3±24.0 and 64.1±25.2% for Class I and II, respectively (p<0.00001). Serial dilution studies comparing the screening test with antiglobulin-enhanced lymphocytotoxicity suggested that NBG correlated with antibody titer. In our center,...Continue Reading

References

Dec 2, 2004·Blood·Christopher C SillimanLynn K Boshkov
Jun 11, 2005·Mayo Clinic Proceedings·Ognjen Gajic, S Breanndan Moore
Aug 29, 2006·Transfusion·Jürgen Bux
Mar 8, 2007·British Journal of Haematology·Jürgen Bux, Ulrich J H Sachs
Jan 15, 2010·Transfusion·Ram M KakaiyaUNKNOWN National Heart, Lung, and Blood Institute (NHLBI) Retrovirus Epidemiology Donor Study-II

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