ABO-immune complex formation and impact on platelet function, red cell structural integrity and haemostasis: an in vitro model of ABO non-identical transfusion.

Autor: Zaffuto BJ; James P. Wilmot Cancer Center, University of Rochester Medicine, Rochester, NY, USA.; Department of Medicine, University of Rochester Medicine, Rochester, NY, USA., Conley GW; Department of Pathology and Laboratory Medicine, University of Rochester Medicine, Rochester, NY, USA., Connolly GC; James P. Wilmot Cancer Center, University of Rochester Medicine, Rochester, NY, USA.; Department of Medicine, University of Rochester Medicine, Rochester, NY, USA., Henrichs KF; Department of Pathology and Laboratory Medicine, University of Rochester Medicine, Rochester, NY, USA., Francis CW; James P. Wilmot Cancer Center, University of Rochester Medicine, Rochester, NY, USA.; Department of Medicine, University of Rochester Medicine, Rochester, NY, USA., Heal JM; James P. Wilmot Cancer Center, University of Rochester Medicine, Rochester, NY, USA.; Department of Medicine, University of Rochester Medicine, Rochester, NY, USA., Blumberg N; Department of Pathology and Laboratory Medicine, University of Rochester Medicine, Rochester, NY, USA., Refaai MA; Department of Pathology and Laboratory Medicine, University of Rochester Medicine, Rochester, NY, USA.
Jazyk: angličtina
Zdroj: Vox sanguinis [Vox Sang] 2016 Apr; Vol. 110 (3), pp. 219-26. Date of Electronic Publication: 2015 Nov 03.
DOI: 10.1111/vox.12354
Abstrakt: Background: Transfusion of ABO non-identical platelets has been associated with fatal haemolytic reactions, increased red cell transfusion needs and other adverse effects, but the practice of ABO matching in platelet transfusion is controversial. Immune complexes can be formed from the anti-A and/or anti-B antibodies and ABO soluble antigen(s) present in donor and recipient plasma after ABO non-identical transfusions. We hypothesized that these immune complexes affect recipient red cell structural integrity, platelet function and haemostasis.
Study Design and Methods: Haemolysis, platelet function and haemostatic function were assessed before and after incubation of recipient red cells, platelets and whole blood with normal saline controls, ABO-identical plasma controls or in vitro-generated ABO-immune complexes.
Results: ABO-immune complexes caused significantly increased haemolysis (P < 0·001), inhibition of platelet function (P = 0·001) and disruption of clot formation kinetics (P < 0·005) in both group A and O recipient samples.
Conclusions: Substantial changes in platelet function, red cell integrity and haemostasis occur after in vitro exposure to immune complexes. These in vitro findings may explain, in part, previously observed associations of ABO non-identical platelet transfusions with adverse effects including increased red cell transfusion needs, organ failure and mortality.
(© 2015 International Society of Blood Transfusion.)
Databáze: MEDLINE
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