背景：当供体血浆具有异常高的抗A和抗B滴度时，在非O组受者中，轻度ABO不相容的单采血小板输注会带来溶血性输血反应的风险。目的是确定溶血素测试是否可以用作预测高滴度O组血小板单采供体的筛选工具。
方法：一项前瞻性研究，使用O组血小板捐献者的样本，同时进行溶血素测试和抗体滴定测试。还对悬浮在血小板添加剂溶液(PAS)中的产物进行抗体滴定。针对抗体滴定评估溶血素测试的诊断准确性。使用卡方检验和Mann-WhitneyU检验来确定溶血素测试和抗体滴定之间的关系。
结果：在107组O血小板捐献中，供体中抗A和抗B滴度中位数分别为32（8-128）和32（4-256），分别。在18％的捐赠中观察到ABO抗体的高滴度（≥128），而69%的捐赠中溶血素检测呈阳性。溶血素测试结果与抗体滴定结果显著不同(P=0.03)。溶血素测试具有较高的敏感性（89％），具有很强的阴性预测值（94％）。悬浮在PAS中的产物均不具有高滴度抗体。
结论：采用溶血素测试作为筛选工具可能会标记大量单位（69％）不适合ABO不相容的血小板输注。或者，鉴定具有高抗体滴度或阳性溶血素测试的供体并选择性地将其产品悬浮在PAS中可能是一种具有成本效益的方法，并且当然可以防止产品中的高滴度抗体。
BACKGROUND: Minor ABO-incompatible apheresis platelet transfusion poses a risk of hemolytic transfusion reactions in non-Group O recipients when donor\'s plasma possesses unusual high titers for anti-A and anti-B. The aim was to determine whether the hemolysin test can be used as a screening tool to predict high-titer Group O platelet apheresis donors.
METHODS: A prospective
study, with Group O platelet donor\'s samples, was tested for hemolysin test and antibody titration test in parallel. Antibody titration was also performed on products suspended in platelet additive solution (PAS). Hemolysin test was assessed for diagnostic accuracy against antibody titration. Chi-square test and Mann-Whitney U-test were used to determine the relationship between the hemolysin test and antibody titration.
RESULTS: Among 107 Group O platelet donations, median anti-A and anti-B titers in donors were 32 (8-128) and 32 (4-256), respectively. High titer (≥128) for ABO antibodies was seen in 18% of donations, whereas hemolysin test was positive in 69% of donations. Hemolysin test results differ significantly with antibody titration results (P = 0.03). Hemolysin test had higher sensitivity (89%) with a strong negative predictive value (94%). None of the products suspended in PAS had high-titer antibodies.
CONCLUSIONS: Adopting hemolysin test as a screening tool may label a large number of units (69%) unsuitable for ABO-incompatible platelet transfusion. Alternatively identifying donors with high antibody titer or positive hemolysin test and selectively suspending their product in PAS may be a cost-effective approach and certainly prevent high-titer antibodies in the product.
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