Analysis of red cell alloimmunization in multi transfused patients at a Tertiary care teaching hospital

Abstract

Background: Red blood cell (RBC) alloimmunization is an immune response against foreign RBC antigens; this generally occurs after sensitization due to multiple blood transfusions and pregnancies. Antibody detection plays a critical role in transfusion medicine as it can detect irregular or unexpected antibodies. This study was done to know the frequency and specificity of unexpected red cell antibodies in the multitransfused patients. Materials and Methods: This prospective study was done in the Department of Immuno-Haematology and Blood Transfusion. Antibody screening of 100 multitransfused patients with initial negative antibody screen was carried out prior to compatibility testing and followed for a period of 12 months for each transfusion. Depending on the results, patients were given corresponding antigen-negative blood units. Results: In this study, the rate of alloimmunization was 7%. Total number of samples that were positive for irregular alloantibodies were 4 of 54 cases of thalassemia, that is, 7.4%, whereas 3 of 40, that is, 7.5%, cases of solid malignancies developed alloantibodies. None of the patients of chronic kidney disease formed any alloantibody. Anti-K antibody was the most frequent antibody detected in 3 of 7, that is, 42.8% patients. Anti-E was the second most frequent antibody observed in 2 of 7, that is, 28.57%. However, anti-c and anti-M were detected in one each of 7, that is, in 14.28% each. Conclusion: It is concluded here that red cell alloimmunization should not be overlooked in multitransfused patients. To avoid the effects of alloimmunization, routine RBC antibody screening at set time intervals after transfusion should be performed.

Prevalence of Kell Blood Group Antigens among Blood Donors & Impact of its Alloimmunization in Multi-transfused Thalassemia & Sickle Cell Disease Patients with Recommendation of Transfusion Protocol—Need of the Hour

“…In the study by Anjali Handa et. al, anti-K was most common allo-antibody (42.8%) followed by anti E (28.57%) [10] . Dhawan et al and Roopam et al also found similar results, where anti-K was more frequent [11,12] .…”

Phenotyping of clinically significant blood group antigens among the South Indian donor population

“…It has been explicitly shown that the antibodies to Rh-K and MNS blood group antigens are among the commonly reported specificities in these studies. 6 , 7 , 8 Only a few studies (predominantly from the northern and western parts of the country) have reported the frequencies of clinically significant antigens among their donor population. 9 - 14 As shown in the present study, the R1R1 and R1r (among D+ donors) and rr (among the D- donors) were found to be the most frequent Rh antigen phenotypes in virtually all the studies conducted in India.…”

The influence of HLA allele and haplotype on RhE alloimmunization among pregnant females in the Chinese Han population

“…Most RBC alloantibodies may lead to serious or fatal clinical consequences, including acute or delayed haemolytic reactions, anaemia and haemolytic disease of the newborn [1,3]. The incidence of RBC alloimmunization after blood transfusion is the most reported at present and different studies with specific populations have come to different conclusions, with data between 1% and 10% [4][5][6].…”