Kenji M Cunnion1,2,3, Pamela S Hair1, Neel K Krishna1,4, Megan A Sass1, Clinton W Enos1, Pamela H Whitley5, Lanne Y Maes5, Corinne L Goldberg6. 1. Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia. 2. Children's Specialty Group, Norfolk, Virginia. 3. Department of Pediatrics, Children's Hospital of the King's Daughters, Norfolk, Virginia. 4. Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, Virginia. 5. American Red Cross, Norfolk, Virginia. 6. American Red Cross Blood Services, Durham, North Carolina.
Abstract
BACKGROUND: The agglutination-based cross-matching method is sensitive for antibody binding to red blood cells but is only partially predictive of complement-mediated hemolysis, which is important in many acute hemolytic transfusion reactions. Here, we describe complement hemolysis using human erythrocytes (CHUHE) assays that directly evaluate complement-mediated hemolysis between individual serum-plasma and red blood cell combinations. The CHUHE assay is used to evaluate correlations between agglutination titers and complement-mediated hemolysis as well as the hemolytic potential of plasma from type A blood donors. STUDY DESIGN AND METHODS: Plasma or serum from each type A blood donor was incubated with AB or B red blood cells in the CHUHE assay and measured for free hemoglobin release. RESULTS: CHUHE assays for serum or plasma demonstrate a wide, dynamic range and high sensitivity for complement-mediated hemolysis for individual serum/plasma and red blood cell combinations. CHUHE results suggest that agglutination assays alone are only moderately predictive of complement-mediated hemolysis. CHUHE results also suggest that plasma from particular type A blood donors produce minimal complement-mediated hemolysis, whereas plasma from other type A blood donors produce moderate to high-level complement-mediated hemolysis, depending on the red blood cell donor. CONCLUSION: The current results indicate that the CHUHE assay can be used to assess complement-mediated hemolysis for plasma or serum from a type A blood donor, providing additional risk discrimination over agglutination titers alone.
BACKGROUND: The agglutination-based cross-matching method is sensitive for antibody binding to red blood cells but is only partially predictive of complement-mediated hemolysis, which is important in many acute hemolytic transfusion reactions. Here, we describe complement hemolysis using human erythrocytes (CHUHE) assays that directly evaluate complement-mediated hemolysis between individual serum-plasma and red blood cell combinations. The CHUHE assay is used to evaluate correlations between agglutination titers and complement-mediated hemolysis as well as the hemolytic potential of plasma from type A blood donors. STUDY DESIGN AND METHODS: Plasma or serum from each type A blood donor was incubated with AB or B red blood cells in the CHUHE assay and measured for free hemoglobin release. RESULTS: CHUHE assays for serum or plasma demonstrate a wide, dynamic range and high sensitivity for complement-mediated hemolysis for individual serum/plasma and red blood cell combinations. CHUHE results suggest that agglutination assays alone are only moderately predictive of complement-mediated hemolysis. CHUHE results also suggest that plasma from particular type A blood donors produce minimal complement-mediated hemolysis, whereas plasma from other type A blood donors produce moderate to high-level complement-mediated hemolysis, depending on the red blood cell donor. CONCLUSION: The current results indicate that the CHUHE assay can be used to assess complement-mediated hemolysis for plasma or serum from a type A blood donor, providing additional risk discrimination over agglutination titers alone.
Authors: Connie M Arthur; Satheesh Chonat; Ross Fasano; Marianne E M Yee; Cassandra D Josephson; John D Roback; Sean R Stowell Journal: Transfus Med Rev Date: 2019-10-18
Authors: Kenji M Cunnion; Lisa M Feagin; Michael F Chicella; Cortney L Kaszowski; Pamela S Hair; Jessica Price; William C Owen Journal: Case Rep Hematol Date: 2019-01-30