Alloantibody assays and outcome of platelet transfusions

In this thesis we deal with two aspects of alloantibody assays: (i) test characteristics and (ii) performance of tests in different patient populations. The first part of this thesis focuses on the technical aspects of antibody detection guided by the following questions: 1. Is a technique using standardized antigens (ELIHLA) as sensitive as techniques using panel cells (LCT, LIFT, PIFT) and are the results of these 4 different techniques related? 2. Are the results of a technique that detects IgG bound to transfused platelets in vivo (IVBI-PIFT) related to those of an in vitro technique using panel cells ( crossmatchPIFT) or using standardized platelet antigens (ELIHLA)? 3. Is binding of IgG to transfused platelets in vivo related to poor platelet recovery? 4. Can the visual scoring method of the IVBI-PIFT reliably be objectivated by a mathematical method of histogram subtraction? The second part of the thesis deals with the predictive value of alloantibody tests on platelet recovery of random platelet transfusions in a non-selected patient population and of HLA-matched platelet transfusions in a heavely selected patient population. In some of the studies non-immunological factors jeopardizing the survival of platelets were taking into account too. These value of alloantibody assays were studied by the following questions: 1. What is the prevalence of immune and non-immune causes of platelet transfusion failures in a non-selected patient population? 2. Which alloantibody tests and what non-immune causes are best related to platelet transfusion failures in a non-selected patient population?

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