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

Abstract

Background: The aim of the study was to analyze the prevalence of Kell antigen and its correlation to major blood groups, ABO & Rh system in Eastern India. There was simultaneous retrospective analysis of Kell alloimmunization to find out the implication and recommendation of transfusion protocols in multi-transfused thalassemia and sickle cell patients. Methods: The study was a prospective observational conducted on 3000 donors for KELL and ABO grouping. Retrospective analysis was made to identify common alloantibodies in multi-transfused patients. Results: The overall prevalence of Kell antigen was 2.6% (80) in 3000 donors. Among male, it was highly prevalent i.e. 2.77% and in females 0.65%. Kell antigen was highly prevalent among AB donors, i.e. 5.1%. It was 2.5% in A, 2.9% in B, 1.9% in Blood Donors. Kell prevalence was high in Rh D positive donors, i.e. 2.72% and was 1.72% among Rh D negative donors. Anti-K was the 3rd most common alloantibody detected in 638 cases of multi-transfused thalassemia and sickle cell (SCD) patients (9.25%). Anti-E (42.6%)was most common entity followed by anti-c (24.0%). Conclusion: The higher incidence of Kell prevalence in AB & Rh D Positive Blood groups and also in male persons indicate that there should be a donor database and knowledge of red cell antigen prevalence in a population. This will help blood centers in providing antigen negative compatible blood units to patients with corresponding alloantibodies. Hemolytic transfusion reactions due to Kell alloimmunization are of a significant severity. Prevalence of Kell alloantibody is high among multi-transfused patients and is next to anti E & anti c. Kell sensitized mothers may also cause serious consequences like hemolytic disease of fetus and newborn. Therefore, it is suggested that extended phenotyping including Kell blood group antigen should be implemented in cases of multi-transfused patients. Keywords: Blood donors, Extended phenotyping, Kell, Multitransfused thalassemia patients, Multitransfused sickle cell disease patients