Testing for Homologous Blood Transfusion in Elite Athletes - RPAH AT ATHENS 2004.

Abstract

Following the 2000 Sydney Olympics and the introduction of testing for erythropoietin in elite athletes, it became apparent that many athletes had reverted to blood doping using homologous and autologous transfusions. The Science and Industry Against Blood doping research consortium approached Dr Nelson at RPAH to determine if a test could be developed to detect recent blood transfusions. A grant was provided by the US Anti-Doping Agency to develop a flow cytometric assay which detects the expression of a panel of minor blood group antigens. Most blood bank reagents are IgM and are not satisfactory as they cause aggregation. A series of IgG polyclonal antibodies were sourced and the optimal titre of each antibody to detect minor negative and positive red cell populations in in vitro mixtures was determined. The test was validated by four Sydney flow cytometry laboratories who tested unknown samples in a proficiency exercise. In April 2004, IOC, WADA and ATHOC agreed to introduce the test into the Athens laboratory in time for the 2004 Olympics with assistance from RPAH. From May till August, RPAH sourced suitable antibodies, performed antibody titrations, provided a standard operating procedure, consulted daily with both the Athens lab and the Anti-doping lab in Lausanne and conducted a series of 3 Proficiency Testing exercises for both labs. No false positives were found in 254 antibody/sample test combinations. The Athens lab used a panel which included antibodies to C, c, E, Jka, Jkb, Fyb, Fyb, M, N and S. Reagents for anti s, K and e were also provided by RPAH. Two weeks before the Games, the lab personnel moved into the IOC Athens Testing lab. A total of 350 endurance athletes were tested. This included placegetters plus randomly selected competitors.