Immunohematology Journal of Blood Group Serology and Education Celebrating 2 Ye5ars Volume 25, Number 3, 2009 Immunohematology Journal of Blood Group Serology and Education Volume 25, Number 3, 2009 Contents Letter to the Readers 89 Introduction to Vol. 25, No. 3, of Immunohematology J.P. AuBuchon Invited Review: Milestones Series 90 Pioneers of blood group serology in the United States: 1950–1990 S.R. Pierce Review 95 MNS blood group system: a review M.E. Reid Review 102 Quality activities associated with hospital tissue services C.M. Hillberry and A.J. Schlueter Review 107 Logistical aspects of human surgical tissue management in a hospital setting B.M. Alden and A.J. Schlueter Review 112 Lewis blood group system review M.R. Combs Review 119 Recognition and management of antibodies to human platelet antigens in platelet transfusion–refractory patients R.R. Vassallo Review 125 Detection and identification of platelet antibodies and antigens in the clinical laboratory B.R. Curtis and J.G. McFarland Review 136 Investigating the possibility of drug-dependent platelet antibodies J.P. AuBuchon and M.F. Leach 141 Announcements 142 Advertisements 146 Instructions for Authors Editors-in-Chief Managing Editor Sandra Nance, MS, MT(ASCP)SBB Cynthia Flickinger, MT(ASCP)SBB Philadelphia, Pennsylvania Philadelphia, Pennsylvania Connie M. Westhoff, PhD, MT(ASCP)SBB Technical Editors Philadelphia, Pennsylvania Christine Lomas-Francis, MSc New York City, New York Senior Medical Editor Geralyn M. Meny, MD Dawn M. Rumsey, ART(CSMLT) Philadelphia, Pennsylvania Glen Allen, Virginia Associate Medical Editors David Moolten, MD Ralph R. Vassallo, MD Philadelphia, Pennsylvania Philadelphia, Pennsylvania Editorial Board Patricia Arndt, MT(ASCP)SBB Brenda J. Grossman, MD Joyce Poole, FIBMS Pomona, California St. Louis, Missouri Bristol, United Kingdom James P. AuBuchon, MD W. John Judd, FIBMS, MIBiol Mark Popovsky, MD Lebanon, New Hampshire Ann Arbor, Michigan Braintree, Massachusetts Martha R. Combs, MT(ASCP)SBB Christine Lomas-Francis, MSc Marion E. Reid, PhD, FIBMS Durham, North Carolina New York City, New York New York City, New York Geoffrey Daniels, PhD Gary Moroff, PhD S. Gerald Sandler, MD Bristol, United Kingdom Rockville, Maryland Washington, District of Columbia Anne F. Eder, MD John J. Moulds, MT(ASCP)SBB Jill R. Storry, PhD Washington, District of Columbia Shreveport, Louisiana Lund, Sweden George Garratty, PhD, FRCPath Paul M. Ness, MD David F. Stroncek, MD Pomona, California Baltimore, Maryland Bethesda, Maryland Emeritus Editorial Board Delores Mallory, MT(ASCP)SBB Supply, North Carolina Editorial Assistant Production Assistant Judith Abrams Marge Manigly Proofreader Copy Editor Lucy Oppenheim Electronic Publisher Mary L. Tod Wilson Tang Immunohematology is published quarterly (March, June, September, and December) by the American Red Cross, National Headquarters, Washington, DC 20006. Immunohematology is indexed and included in Index Medicus and MEDLINE on the MEDLARS system. The contents are also cited in the EBASE/Excerpta Medica and Elsevier BIOBASE/Current Awareness in Biological Sciences (CABS) databases. The subscription price is $40.00 (U.S.) and $50.00 (foreign) per year. Subscriptions, Change of Address, and Extra Copies: Immunohematology, P.O. BOX 40325, Philadelphia, PA 19106 Or call (215) 451-4902 Web site: www.redcross.org/immunohematology Copyright 2009 by The American National Red Cross ISSN 0894-203X Letter to Readers Introduction to Vol. 25, No. 3, of Immunohematology J.P. AuBuchon The increased breadth and depth of the field of transfu- Thus, even if you are not directly involved in testing sion medicine is evident in this issue of Immunohematol- for platelet or HLA antibodies or defining platelet antigens’ ogy, and I am delighted and honored to have been asked to molecular or genomic bases, the platelet focus of this issue serve as its guest editor. will provide an exciting window on a world that a few years Those with accumulations of gray hair, myself includ- ago was far more limited in its understanding and capabili- ed, recall when blood banking meant primarily dealing with ties. So whether these articles will call you to rapt attention RBCs and their antibodies. Platelets presented collection, or offer an interesting insight while you sit back and relax, storage, and logistic problems, but when their transfusion the authors of the articles and I hope you will enjoy them. did not have the desired effect, we usually did not have much to offer the patient or the clinician. Indeed, this jour- James P. AuBuchon, MD nal was begun to facilitate knowledge transfer that would President and CEO, Puget Sound Blood Center be useful to those practicing RBC serology at the bench, Professor of Medicine and of Laboratory Medicine as immunohematology was regarded as synonymous with University of Washington RBC antibody identification. (An early meeting of the edito- 921 Terry Avenue rial board even debated whether to branch out into articles Seattle, WA 98104 about platelets.) How the times have changed! This issue covers the spectrum of what a clinical laboratory scientist may encounter today in a transfusion service, from tissue banking (now an integral part of some transfusion services) to molecular characterizations of RBC and platelet anti- gens. Functional competency in transfusion medicine today requires a wide range of knowledge that extends from the genomic to the clinical! This scope is evident in the articles on platelets, their antigens and antibodies, and their use in hemotherapy assembled for this issue. Refractoriness to platelet transfu- sion, and, indeed, the thrombocytopenia itself, may have an immunologic cause, and articles in this issue lay out strate- gies for identifying and coping with antibody specificities directed at HLA, platelet-specific, and drug-induced deter- minants. Knowledge of the molecular and genomic bases of platelet antigens is no longer of research interest only. Just as genomic typing has entered into practical RBC transfu- sion practice, these abilities offer the opportunity for us to become more specific in our attempts to match platelet donor and recipient and to understand the basis of the im- munogenic discrepancy in the first place. Although not all of the methods described in these articles are likely to be found in every laboratory in the near future, information gained from their broader application will undoubtedly expand all of our capabilities. IMMUNOHEMATOLOGY, Volume 25, Number 3, 2009 89 Invited Review: Milestones in Immunohematology Pioneers of blood group serology in the United States: 1950–1990 S.R. Pierce The human blood groups were discovered in 1900 by in 1943 and was stationed at the newly commissioned U.S. Karl Landsteiner.1 The early decades of the 20th century Naval Hospital at Long Beach, California. It had all the lat- saw prodigious work on blood groups and their applica- est equipment, including a centrifuge that could be used to tion to transfusion, anthropology, forensics, genetics, and separate blood samples quickly into serum and RBCs for parentage testing. The discovery of Rh (reported by Levine ABO typing. Crossmatching was not yet routinely done; do- and Stetson2 in 1939 and in 1940 by Landsteiner and Wie- nors were merely chosen to match the patient’s ABO type. ner3, who may actually have found LW instead) and the After leaving the Navy, Shirley obtained a master’s degree subsequent application of the antiglobulin test by Coombs, in public health from Columbia University and was hired as Mourant, and Race4 in 1945 launched a new and exciting supervisor (later technical director) of the Blood Center of era in blood group serology. During the last half of the 20th Mt. Sinai Hospital in Chicago in 1951. In 1956, Shirley read century, many new blood group antigens were described, of a new certification planned by the AABB and the Ameri- largely through research done in transfusion services and can Society of Clinical Pathologists (ASCP). She was the first immunohematology reference laboratories. In the United to respond. Prerequisites were a master’s degree or higher States, the efforts were mainly those of medical technolo- and 3 years’ blood bank experience. The examination pro- gists. Tube shaking was the order of the day. Before the cess included written and practical components (first given explosion of viral testing and DNA assays, blood group in January 1957), an oral interview, and a written thesis. In serology dominated the scientific sessions of blood bank 1958, Shirley was the first to obtain this “Specialist in Blood meetings, such as the annual meeting of the American As- Banking” (SBB) certification.5,6 sociation of Blood Banks (AABB). The leaders of this era Shirley organized the Pre-Convention Seminar for of serology were widely recognized and respected, often technologists, which became a staple at the AABB Annual referred to simply by their first names by blood bank tech- Meetings; the first, held in 1959, addressed antibody de- nologists eager to keep abreast of the latest blood group tection and identification. With assistance from Marjory happenings. These “stars” were glad to oblige, giving Stroup, she conceived and organized an invitational meet- numerous workshops and lectures and hours of individual ing of leading immunohematology reference laboratory consultation on serologic problems. Most major cities experts; begun in 1968, and later renamed the Invitational had Antibody Clubs to discuss serologic problems and hear Conference