Kickler T S, Braine H G, Ness P M, Koester A, Bias W
Blood. 1983 Feb;61(2):238-42.
Despite the use of HLA-matched platelets for alloimmunized recipients, transfusion failures occur. In order to reduce these failures, we investigated the use of a radiolabeled antiglobulin technique for platelet crossmatching. The principle of the test is that of an indirect Coombs test using 125I labeled goat anti-human IgG. Incompatibility is determined by calculating a radioactivity antiglobulin test (RAGT) index. Using this technique, we performed 89 crossmatches on 19 leukemic or aplastic patients who were refractory to random donor platelets and receiving varying degrees of HLA-matched platelets. Effectiveness of the transfusion was assessed from the posttransfusion corrected platelet count increment (CCI) determined at 1 and 20 hr. When the RAGT index was 1.9 or less, the mean CCI at 1 lhr was 17,570 +/- 7003/cu mm, n = 55. When the RAGT index was 2.0 or greater, the mean CCI was 4237 +/- 4100/cu mm, n = 34. At 20 hr when the RAGT index was 1.9 or less, the mean CCI was 8722 +/- 3143/cu mm, n = 33, and when the index was 2.0 or greater, the mean CCI was 571 +/- 1286/cu mm, n = 23. Using this technique, one false negative resulted. Nine positive crossmatches with good increments at 1 hr were found; at 20 hr, however, the survival of these units was zero. These data suggest that this method is a useful adjunct in the selection of platelets in the refractory patient.
尽管为同种免疫受者使用了 HLA 匹配的血小板，但仍会出现输血失败的情况。为了减少这些失败，我们研究了使用放射性标记抗球蛋白技术进行血小板交叉配型。该测试的原理是使用 125I 标记的山羊抗人 IgG 的间接抗人球蛋白试验。通过计算放射性抗球蛋白试验（RAGT）指数来确定不相容性。使用该技术，我们对 19 名白血病或再生障碍性贫血患者进行了 89 次交叉配型，这些患者对随机供体血小板难治，且接受不同程度的 HLA 匹配血小板。输血效果通过输血后 1 小时和 20 小时测定的校正血小板计数增加值（CCI）进行评估。当 RAGT 指数为 1.9 或更低时，1 小时时的平均 CCI 为 17,570±7003/立方毫米，n = 55。当 RAGT 指数为 2.0 或更高时，平均 CCI 为 4237±4100/立方毫米，n = 34。在 20 小时时，当 RAGT 指数为 1.9 或更低时，平均 CCI 为 8722±3143/立方毫米，n = 33，当指数为 2.0 或更高时，平均 CCI 为 571±1286/立方毫米，n = 23。使用该技术产生了 1 例假阴性结果。发现 9 次交叉配型为阳性，1 小时时增量良好；然而，在 20 小时时，这些单位的存活率为零。这些数据表明，该方法在难治性患者血小板选择中是一种有用的辅助手段。
