TY - JOUR T1 - A retrospective analysis of the value of monocyte monolayer assay results for predicting the clinical significance of blood group alloantibodies. JF - Transfusion//Transfusion Y1 - 2004 A1 - Arndt, Patricia A A1 - Garratty, George KW - *Blood Group Incompatibility/im [Immunology] KW - *Blood Transfusion/ae [Adverse Effects] KW - *Hemolysis KW - *Immunoassay KW - *Isoantibodies/im [Immunology] KW - *Monocytes/im [Immunology] KW - Erythrocyte Aging KW - Female KW - Hemolysin Proteins/im [Immunology] KW - Humans KW - Immunoglobulin G/cl [Classification] KW - Immunoglobulin G/im [Immunology] KW - Male KW - Predictive Value of Tests KW - Pregnancy KW - Retrospective Studies KW - risk KW - ROC Curve AB - BACKGROUND: Cellular assays (e.g., monocyte monolayer assays [MMAs]) have been used to predict the clinical significance of red blood cell (RBC) alloantibodies., STUDY DESIGN AND METHODS: Twenty years of MMA data were retrospectively analyzed to 1) determine the optimal cut point (by correlating MMA results from 46 patients with RBC survival study results and/or laboratory and clinical signs of hemolytic transfusion reactions [HTRs] when incompatible blood was transfused), and 2) determine what percentage of 251 unusual alloantibodies (most to high-incidence antigens) were predicted to be clinically significant., RESULTS: Two MMA cut points (5% and 20%) were chosen using a receiver-operating characteristics curve. No patients with MMA results less than or equal to 5 percent had clinical signs of a reaction; one-third of patients with MMA results 5.1 to 20 percent versus two-thirds with results greater than 20 percent had clinical signs of a HTR after transfusion of incompatible blood. Using 5-percent or 20-percent cut points, 173 (69%) or 97 (39%) of 251 unusual alloantibodies gave positive MMAs, respectively., CONCLUSION: A negative MMA (< or =5%) indicates that incompatible blood can be given without risk of an overt HTR but does not guarantee normal long-term survival of those RBCs. Most unusual alloantibodies are predicted to cause shortened RBC survival, but transfusion of incompatible blood may not result in any clinical or laboratory signs of a HTR. We have used the MMA for approximately 20 years, instead of a 1-hour chromium-51 RBC survival, to aid in the decision to transfuse RBCs incompatible with antibodies to high-incidence antigens. M1 - wdn, 0417360 PB - Arndt,Patricia A. Research Department, American Red Cross Blood Services, Southern California Region, Los Angeles, California, USA. arndtp@usa.redcross.org CY - United States VL - 44 SN - 0041-1132 CP - 9 L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=med5&NEWS=N&AN=15318848 ID - 4418 ER -