Peter David Issitt
Associate Professor Emeritus of Pathology

Primary research objectives continue to involve expansion of knowledge of the serology, genetics and biochemistry of the human blood groups. That knowledge is, in turn, used to improve the safety of the transfusion of red blood cells and to interpret serological findings in patients with hematological disorders.

A major project begun in 1996 that will continue, at least through 1997, involves comparative studies on newly introduced methods for red cell antibody detection and identification in pretransfusion testing. These include solid phase and gel technologies and modifications to these technologies currently being developed in our laboratory. Coupled with this effort are attempts to determine the immunolgoic stimuli and clinical relevance of red cell antibodies detected by some but not all in vitro methods. A parallel study involves the detection and determination of clinical significance of antibodies that behave as agglutinins in tests at low ionic strength but that are not demonstrable by other methods. In addition to the obvious importance of these studies in determining which method(s) provide(s) maximum safety for patients about to receive red cell transfusions is the fact that the recently introduced methods are clearly more amenable to automation than are traditionally used techniques. As automated systems are introduced it will be imperative that we have sufficient knowledge, in terms of test sensitivity and clinical applicability, of the principles on which they are based, to make educated decisions regarding selection of an automated system.

As in previous years, work was performed on Rh system antigens and antibodies (see publication list). A number of samples with partial D phenotypes were identified using monoclonal antibodies specific for different epitopes of D. Other advances were summarized in publications number 2, 6 and 7 on the attached 1996 publication list.

Three previously listed studies were completed and the results published. These comprised studies on alloantibodies made by autoimmunized patients, the occurrence of anti-Di(b) as an autoantibody and the relationships between the antigens e, hr(b) and V.

A large retrospective study on antibodies causative of ABO hemolytic disease of the newborn (HDN) was undertaken and published in abstract form. Contrary to a generally held belief it was shown that anti-A and anti-B cause ABO HDN more frequently and in a more severe form than doses anti-A,B.

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