@article {4418,
	title = {A retrospective analysis of the value of monocyte monolayer assay results for predicting the clinical significance of blood group alloantibodies.},
	journal = {Transfusion//Transfusion},
	volume = {44},
	year = {2004},
	month = {2004},
	pages = {1273 - 81},
	publisher = {Arndt,Patricia A. Research Department, American Red Cross Blood Services, Southern California Region, Los Angeles, California, USA. arndtp@usa.redcross.org},
	address = {United States},
	abstract = {BACKGROUND: Cellular assays (e.g., monocyte monolayer assays [MMAs]) have been used to predict the clinical significance of red blood cell (RBC) alloantibodies., STUDY DESIGN AND METHODS: Twenty years of MMA data were retrospectively analyzed to 1) determine the optimal cut point (by correlating MMA results from 46 patients with RBC survival study results and/or laboratory and clinical signs of hemolytic transfusion reactions [HTRs] when incompatible blood was transfused), and 2) determine what percentage of 251 unusual alloantibodies (most to high-incidence antigens) were predicted to be clinically significant., RESULTS: Two MMA cut points (5\% and 20\%) were chosen using a receiver-operating characteristics curve. No patients with MMA results less than or equal to 5 percent had clinical signs of a reaction; one-third of patients with MMA results 5.1 to 20 percent versus two-thirds with results greater than 20 percent had clinical signs of a HTR after transfusion of incompatible blood. Using 5-percent or 20-percent cut points, 173 (69\%) or 97 (39\%) of 251 unusual alloantibodies gave positive MMAs, respectively., CONCLUSION: A negative MMA (< or =5\%) indicates that incompatible blood can be given without risk of an overt HTR but does not guarantee normal long-term survival of those RBCs. Most unusual alloantibodies are predicted to cause shortened RBC survival, but transfusion of incompatible blood may not result in any clinical or laboratory signs of a HTR. We have used the MMA for approximately 20 years, instead of a 1-hour chromium-51 RBC survival, to aid in the decision to transfuse RBCs incompatible with antibodies to high-incidence antigens.},
	keywords = {*Blood Group Incompatibility/im [Immunology], *Blood Transfusion/ae [Adverse Effects], *Hemolysis, *Immunoassay, *Isoantibodies/im [Immunology], *Monocytes/im [Immunology], Erythrocyte Aging, Female, Hemolysin Proteins/im [Immunology], Humans, Immunoglobulin G/cl [Classification], Immunoglobulin G/im [Immunology], Male, Predictive Value of Tests, Pregnancy, Retrospective Studies, risk, ROC Curve},
	isbn = {0041-1132},
	author = {Arndt, Patricia A and Garratty, George}
}
