Document Detail


Alterations of platelet function and clot formation kinetics after in vitro exposure to anti-A and -B.
MedLine Citation:
PMID:  22624532     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: ABO-mismatched platelets (PLTs) are commonly transfused despite reported complications. We hypothesized that because PLTs possess A and B antigens on their surface, ABO-mismatched transfused or recipient PLTs could become activated and/or dysfunctional after exposure to anti-A or -B in the transfused or recipient plasma. We present here in vitro modeling data on the functional effects of exposure of PLTs to ABO antibodies.
STUDY DESIGN AND METHODS: PLT functions of normal PLTs of all ABO types were assessed before and after incubation with normal saline, ABO-identical plasma samples, or O plasma samples with varying titers of anti-A and anti-B (anti-A/B). Assays used for this assessment include PLT aggregation, clot kinetics, thrombin generation, PLT cytoskeletal function, and mediator release.
RESULTS: Exposure of antigen-bearing PLTs to O plasma with moderate to high titers of anti-A/B significantly inhibits aggregation, prolongs PFA-100 epinephrine closure time, disrupts clot formation kinetics, accelerates thrombin generation, reduces total thrombin production, alters PLT cytoskeletal function, and influences proinflammatory and prothrombotic mediator release.
CONCLUSIONS: Our findings demonstrate a wide range of effects that anti-A/B have on PLT function, clot formation, thrombin generation, PLT cytoskeletal function, and mediator release. These data provide potential explanations for clinical observations of increased red blood cell utilization in trauma and surgical patients receiving ABO-nonidentical blood products. Impaired hemostasis caused by anti-A/B interacting with A and B antigens on PLTs, soluble proteins, and perhaps even endothelial cells is a potential contributing factor to hemorrhage in patients receiving larger volumes of ABO-nonidentical transfusions.
Authors:
Majed A Refaai; Jessie Carter; Kelly F Henrichs; Donna C Davidson; Stephen J Pollock; Ann E Casey; Sherry L Spinelli; Richard P Phipps; Charles W Francis; Neil Blumberg
Publication Detail:
Type:  Evaluation Studies; In Vitro; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-05-25
Journal Detail:
Title:  Transfusion     Volume:  53     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-06     Completed Date:  2013-03-28     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  382-93     Citation Subset:  IM    
Copyright Information:
© 2012 American Association of Blood Banks.
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MeSH Terms
Descriptor/Qualifier:
ABO Blood-Group System / immunology*
Adult
Antibodies / pharmacology*
Blood Coagulation / drug effects*,  physiology
Blood Grouping and Crossmatching
Blood Platelets / drug effects*,  immunology,  physiology*
Female
Humans
Kinetics
Male
Middle Aged
Platelet Aggregation / drug effects,  physiology
Time Factors
Titrimetry
Grant Support
ID/Acronym/Agency:
ES01247/ES/NIEHS NIH HHS; HL095467/HL/NHLBI NIH HHS; HL100051/HL/NHLBI NIH HHS; P30 ES001247/ES/NIEHS NIH HHS; R01 HL095467/HL/NHLBI NIH HHS; RC1 HL100051/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/ABO Blood-Group System; 0/Antibodies
Comments/Corrections

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