Testing previously pregnant first time platelet donors for anti-HLA and HNA antibodies
A Blood Bank Medical Director in Virginia reports that her institution is considering testing previously pregnant first time platelet donors for anti-HLA and HNA antibodies. Her institution's current practice is for women who have had three or more pregnancies which have lasted beyond the 1st trimester to be indefinitely deferred from platelet donation or, if the donor prefers to become a frequent donor, they are offered anti-HLA and anti-HNA testing. The antibody testing is sent to a contracted reference lab that performs the following assays: Neutrophil Antibody, Flow Cytometry and Donor HLA Antibody Screen Class I and II.
The medical director wonders, for donor centers that do such testing, what tests are being done (anti-HLA vs anti-HNA or both), what is the test name, and who does it, and on whom (i.e. all previously pregnant donors or donors who've had more than 2 pregnancies and just once or every time they donate).
The following comments have been submitted in response.
ADDENDA Sept. 30, 2010
- Sandy Linauts, Executive Vice President, Blood Service Laboratories at Puget Sound Blood Center, (attribution used with permission), writes:
"We use the One Lambda assay on the Luminex® and currently only test for HLA antibodies. All female donors of high plasma containing products (Apheresis plasma, apheresis platelets, and AB whole blood from which FFP will be made) are tested annually, regardless of pregnancy status. Keeping track of number of pregnancies, time since last test, etc. was cumbersome with our computer system - thus we felt annual testing was sufficient. A small number of women (about 2 %) do seroconvert when tested the following year."
Submit comments to the e-Network Forum at enetworkforum@cbbsweb.org
Ira A. Shulman, MD
CBBS e-Network Forum Senior Editor & Moderator
W. Tait Stevens, MD
CBBS e-Network Forum Editor & Moderator
Elizabeth M. St. Lezin, MD
CBBS e-Network Forum Associate Editor & Moderator
The e-Network Forum is supported in part by the California Blood Bank Society (CBBS) and the American Red Cross Blood Services (ARCBS) and endorses collegial discussion among blood banking and transfusion medicine professionals. However, neither the CBBS nor the ARCBS in any way endorse the specific views and opinions expressed in the forum. The forum is not intended as a substitute for medical or legal advice and the content should not be relied upon for any medical or legal purposes. Readers should make their own determinations as to: (i) what constitutes appropriate medical, technical, and administrative practices, and (ii) how best to comply with laws and regulations relevant to their questions. For the latter, they should consider consulting, as to any medical matters, a qualified physician, and, as to any legal matters, an attorney familiar with related state and federal laws. The user of the forum, by accessing same, assumes all risks arising out of such use and releases CBBS and their respective members, directors, officers and agents from and against any loss, damage, claim or liability arising out of such use of the Forum.
