Academic Journal
Assessing the reliability of the PAK-LX HLA Class I bead in platelet transfusion compatibility testing.
| Τίτλος: | Assessing the reliability of the PAK-LX HLA Class I bead in platelet transfusion compatibility testing. |
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| Συγγραφείς: | Enten H; American National Red Cross, USA., Liacini A; American National Red Cross, USA., Janes D; American National Red Cross, USA., Stedem R; American National Red Cross, USA., Gaule L; Atrium Health, USA., Berka N; American National Red Cross, USA. Electronic address: Noureddine.berka@redcross.org. |
| Πηγή: | Human immunology [Hum Immunol] 2026 May; Vol. 87 (5), pp. 111711. Date of Electronic Publication: 2026 Mar 13. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier/North-Holland Country of Publication: United States NLM ID: 8010936 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1166 (Electronic) Linking ISSN: 01988859 NLM ISO Abbreviation: Hum Immunol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [New York] Elsevier/North-Holland. |
| Ιατρικοί όροι (MeSH): | Isoantibodies*/blood , Histocompatibility Antigens Class I*/immunology , Histocompatibility Testing*/methods , Blood Platelets*/immunology , Platelet Transfusion*, Humans ; Female ; Reproducibility of Results ; Male ; Adult ; Middle Aged |
| Περίληψη: | Purpose: PAK-LX, a Luminex-based assay for detecting platelet-specific glycoproteins and HLA class I antibodies, has shown limited reliability for HLA immunization. A prior study reported a 37% discrepancy compared to the single antigen bead (SAB) assay. The current study expands the cohort size to further investigate this discrepancy and uncover patterns that may explain the divergence. Methods: A total of 137 individuals from two American Red Cross Histocompatibility laboratories (Charlotte, NC and Portland, OR) were screened using both PAK-LX (Werfen, Inc) and SAB (ThermoFisher, Inc). Data included demographics, antibody positivity, discordance rates, mean fluorescence intensity (MFI), and calculated panel reactive antibody (cPRA). Results: SAB detected HLA class I antibodies in 73% of participants; 36% showed discordance, with 98% being PAK-LX false negatives. Mean cPRA among discordant cases was 29% (range: 2-96%). Missed antibodies had MFIs typically below 6,000 but ranged from 2,000 to 19,000. Conclusion: PAK-LX demonstrates reduced sensitivity for the detection of HLA class I antibodies compared with single-antigen bead (SAB) assays and may fail to identify HLA alloantibodies implicated in immune-mediated platelet transfusion refractoriness. Accordingly, PAK-LX should not be used as a standalone screening assay, and confirmatory testing with SAB is recommended when immune-mediated platelet refractoriness is suspected. (Copyright © 2026 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Alloimmunization; Human leukocyte antigens; Platelet refractoriness |
| Substance Nomenclature: | 0 (Isoantibodies) 0 (Histocompatibility Antigens Class I) |
| Entry Date(s): | Date Created: 20260313 Date Completed: 20260710 Latest Revision: 20260710 |
| Update Code: | 20260711 |
| DOI: | 10.1016/j.humimm.2026.111711 |
| PMID: | 41825092 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1879-1166 |
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| DOI: | 10.1016/j.humimm.2026.111711 |