Possible insensitivity of the polybrene antibody screen to detect anti-Jka.
ABSTRACT An acute hemolytic transfusion reaction (AHTR) occurred in a 28-yr-old gravida immediately after transfusion with leukocyte-reduced red cells. The patient gave no history of prior transfusion. Initial serologic testing by the polybrene method was negative for both antibody screening and cross-matching. Further testing by the indirect anti-globulin test (IAT) demonstrated the presence of anti-Jka antibodies. These observations suggest a limitation in polybrene testing for Jka antibodies associated with hemolytic transfusions. Caution is advised when the polybrene test is used as the sole determinant for anti-Jka.
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ABSTRACT: The Kidd system antibodies, if undetected, can cause immediate or delayed hemolytic transfusion reactions as well as hemolytic disease of the newborn. There have been anecdotal reports about the inefficiency of the manual Polybrene test in detecting these antibodies. Here, we sought to determine the sensitivity of the manual Polybrene test in detecting anti-Jk(a) and anti-Jk(b) antibodies and Jk(a) and Jk(b) antigens. Ten archived anti-Jk(a)/Jk(b) antibody positive human sera were examined by both the manual Polybrene test and the indirect antiglobulin test using polyspecific antibodies, monospecific anti-IgG antibodies and anti-C3 antibodies. Furthermore, 40 randomly selected donor blood samples were collected and phenotyped for the frequencies of Jk(a) and Jk(b) antigens using the manual Polybrene test and the indirect antiglobulin test. The results from these tests were further confirmed by saline tube tests. The manual Polybrene test displayed an overall sensitivity of 60% in detecting anti-Jk(a) and anti-Jk(b) antibody. Specifically, it had a sensitivity of 57.14% for anti-Jk(a) antibody and a sensitivity of 66.7% for anti-Jk(b) antibody. Furthermore, the manual Polybrene test exhibited a sensitivity of 46.15% for Jk(a) antigen and a sensitivity of 77.42% for Jk(b) antigen. The manual Polybrene test has a very low sensitivity in detecting anti-Jk(a) and anti-Jk(b) antibody, especially anti-Jk(a) antibody. It is also a very insensitive test for detecting Jk(a) antigen.Scandinavian journal of clinical and laboratory investigation 11/2009; 69(7):797-800. DOI:10.3109/00365510903272570 · 2.01 Impact Factor