A retrospective analysis of the value of monocyte monolayer assay results for predicting the clinical significance of blood group alloantibodies.

TitleA retrospective analysis of the value of monocyte monolayer assay results for predicting the clinical significance of blood group alloantibodies.
Publication TypeJournal Article
Year of Publication2004
AuthorsArndt PA, Garratty G
JournalTransfusion//Transfusion
Volume44
Issue9
Pagination1273 - 81
Date Published2004
ISBN Number0041-1132
Other Numberswdn, 0417360
Keywords*Blood Group Incompatibility/im [Immunology], *Blood Transfusion/ae [Adverse Effects], *Hemolysis, *Immunoassay, *Isoantibodies/im [Immunology], *Monocytes/im [Immunology], Erythrocyte Aging, Female, Hemolysin Proteins/im [Immunology], Humans, Immunoglobulin G/cl [Classification], Immunoglobulin G/im [Immunology], Male, Predictive Value of Tests, Pregnancy, Retrospective Studies, risk, ROC Curve
Abstract

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 (

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