Provision ofKEL1‐negative blood to obstetric patients: a 3‐year single‐institution retrospective review

Abstract

Although the findings demonstrate feasibility of providing KEL1-negative RBCs to women of childbearing potential, evidence for clinical benefit is lacking. The low prevalence of KEL1 in blood donors, the lack of significant differences in alloimmunization rates, and no cases of HDFN during the study period questions the clinical benefit of such a policy.

Red blood cell alloimmunization in pregnancy during the years 1996‐2015 in Iceland: a nation‐wide population study

“…However, the number of women analyzed who had received transfusions was small, and the matching policies were not uniform in that multinational study. Another study questioned the routine provision of Kell‐matched blood to obstetric patients, despite feasibility, because evidence of a clinical benefit was lacking …”

“…Another study questioned the routine provision of Kellmatched blood to obstetric patients, despite feasibility, because evidence of a clinical benefit was lacking. 21 A recent study of newborns who had positive DATs in Iceland indicated that, in five of eight infants who required exchange transfusions, Rhesus antibodies were implicated, including four who had anti-D and one who had anti-c/ anti-E. 22 In the present study, severe HDFN requiring intrauterine and/or exchange transfusion occurred in 3.6% of fetuses in all pregnancies complicated by CSA, which is comparable to a rate of 3.7% in at-risk fetuses reported in a Dutch study of non-anti-D antibodies. 6 However, only anti-D, either alone or with other antibodies, and anti-c were associated with severe HDFN in our study.…”

The prevalence of anti‐K in Canadian prenatal patients

“…In the United States, a single hospital in Boston, Beth Israel Deaconess, recently reported a trial of the provision of K– RBCs to patients admitted to the obstetric ward. Provision of K– units was found to be technically feasible, but there was no impact on the prevalence of anti‐K . However, with only 227 patients, the study lacked statistical power to demonstrate a difference in alloimmunization rates.…”

Haemolytic disease of the fetus and newborn: advancements in precision and prevention

“…As RBC genotyping programs become more commonplace at the blood collection facilities, more antigen negative units may found in blood bank inventories, making implementation easier [21]. Future energy around broad based antigen matching transfusion policies throughout the world may improve results, but the use of antigen matching in a single hospital or regional areas alone, for example in the United States, will not provide a protection of the population, although it should protect the individual patient [22]. Prevention efforts can also focus on persons who already have predisposition to the disorder in order to prevent additional morbidity and mortality from worsening of the disease, also called second or third line prevention.…”