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- W3201161721 abstract "Abstract Background Solid‐phase platelet crossmatch (PXM) testing is used to help manage patients with platelet transfusion‐refractoriness. Recently, we published the first report of false‐negative PXM results from prozone effect that was mitigated using sample dilution. This study aimed to describe the prevalence of PXM prozone effect and the levels of class I HLA antibodies (HLA‐Abs) associated with positive PXM results and with false‐negative PXM results from prozone effect. Study Design and Methods A cross‐sectional study of patients undergoing PXM testing from July 2019 through December 2020 was performed. All PXM tests were run simultaneously using undiluted and 1:4 diluted patient plasma. Prozone effect was defined as a negative PXM result using undiluted patient plasma but a positive PXM result using 1:4 diluted patient plasma. Results Among 59 patients, 830 individual ABO‐compatible PXM results yielded an overall positivity rate of 25.8% (214/830) and a false‐negative rate from prozone effect of 4.7% (10/214). Among the 28 patients with class I HLA‐Ab testing and no other anti‐platelet antibodies, maximum HLA‐Ab mean fluorescence intensity (MFI) was significantly associated with a positive PXM result ( p < .0001; AUC approx. 0.9) and categorized into negative (<3700), indeterminate (3700–10300), and positive (>10300) maximum HLA‐Ab MFI zones. Maximum HLA‐Ab MFI, however, was not associated with prozone effect ( p = .17; AUC approx. 0.6). Discussion While there is a strong predictive association between class I HLA‐Ab levels and positive PXM results, PXM prozone effect is a common occurrence not associated with class I HLA‐Ab levels, so additional testing with diluted samples should be considered." @default.
- W3201161721 created "2021-09-27" @default.
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- W3201161721 date "2021-09-15" @default.
- W3201161721 modified "2023-10-12" @default.
- W3201161721 title "Prozone rates in the <scp>solid‐phase</scp> platelet crossmatch assay and correlation with class I <scp>HLA</scp> antibody levels" @default.
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- W3201161721 doi "https://doi.org/10.1111/trf.16660" @default.
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