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Titerbestämning av anti-A och anti-B i trombocytenheter för transfusion över ABO gränsen: utvärdering av rutinanalys och utveckling av en screeningmetod
Kristianstad University, Faculty of Natural Science.
2018 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesisAlternative title
Anti-A and anti-B titers in platelets for transfusion across ABO : evaluation of a routine analyze and implementation of a screening method (English)
Abstract [sv]

Trombocyter är suspenderade i plasma som innehåller antikroppar mot de blodgruppsantigen som saknas på erytrocyterna. För att minimera risken för en hemolytisk reaktion bestäms titern av anti-A och anti-B. Gelkortsteknik används för att detektera antikropp-antigensreaktioner och baseras på agglutinationer i en gel. Syftet med studien var att undersöka titern av anti-A och anti-B i trombocytenheter, samt att utvärdera en rutinanalys och utveckla en screeningmetod. I studien analyserades enheter av blodgrupp O och A. De kontrollerades mot anti-A och/eller anti-B både för IgG och IgM antikroppar. En screeningmetod utvecklades för att kunna screena O-enheterna och en gräns på 1:100 respektive 1:250 undersöktes. Resultatet kunde påvisa en stor skillnad i titer mellan O-och A-enheter. Titern skiljer sig signifikant beroende på om titern bestäms i plasma eller från den färdiga (utspädda) enheten. En screeningmetod på 1:100 påvisade att 86 % av enheterna hade bedömts som hög titer och en screeningmetod på 1:250 visade att andelen sjönk till 31 %. Geltekniken är en känslig metod och är beroende av kompetent personal vid avläsning. En del studier visar liknande resultat men andelen enheter med hög titer varierar och likaså metoder och titergräns. Detta påvisar svårigheterna i att bestämma en kritisk titer och att förutse risker hos patienten. Andra faktorer tros också kunna påverka riskerna. Införande av en screeningmetod på 1:250 kan öka antalet enheter som kan transfunderas över ABO-barriären.

Abstract [en]

Platelets are suspended in plasma containing antibodies to the blood group antigen missing on the erythrocytes. To minimize the risk of hemolytic reaction, the titrers of anti-A and anti-B are determined. The gel test is used to detect antibody-and antigen responses and is based on agglutinations in gel. The purpose was to investigate the titers of anti-A and/or anti-B in platelets. A routine analysis was evaluated and a screening method was implemented. In the study, units of blood group O and A were analyzed. They were checked against anti-A and anti-B for both IgG and IgM antibodies. A screening method was developed to screen the O-units and a limit of 1:100 and 1:250 was used. The results showed great difference in titers between O and A units. The titers differ significantly depending on whether the titers are determined in plasma or from the finished (diluted) unit. A screening method at 1:100 showed that 86 % of the units was rated as high titer while a screening method of 1:250 showed that this was reduced to 31 %. Gel technology is a sensitive method and is dependent on competent staff when reading the agglutinations. Some studies show similar results, but the proportion of high titer units, methods and critical titers varies. It proves the difficulty in determining a critical titer and predicting risks for the patient. Other factors are also believed to influence the risks. Implementation of a 1:250 screening method is believed to increase the number of units that can be transfused over the ABO barrier.

Place, publisher, year, edition, pages
2018. , p. 39
Keywords [en]
Platelets, titer, anti-A, anti-B, hemolysis, gel test
Keywords [sv]
Trombocyter, titer, anti-A, anti-B, hemolys, gelteknik
National Category
Biomedical Laboratory Science/Technology
Identifiers
URN: urn:nbn:se:hkr:diva-18623OAI: oai:DiVA.org:hkr-18623DiVA, id: diva2:1242250
Educational program
Bachelor of Science in Biomedical Laboratory Science
Supervisors
Examiners
Available from: 2018-09-06 Created: 2018-08-27 Last updated: 2018-09-06Bibliographically approved

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