Red Blood Cell Alloimmunization in Multi - transfused Patients: A Bicentric Study in India

Agrawal, Amit; Mathur, Ankit; Dontula, Sanjana; Jagannathan, Latha

doi:10.4103/2455-8893.178005

Cited by 21 publications

(20 citation statements)

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“…In our study, the rate of alloimmunization was 7.5 per cent, which was comparable to other Indian studies (Table II)214232425262728293031. Single-specific alloantibodies were detected among seven patients.…”

Section: Discussionsupporting

confidence: 90%

Molecular genotyping of clinically important blood group antigens in patients with thalassaemia

Kulkarni¹,

Choudhary²,

Gogri³

et al. 2018

Indian J Med Res

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Background & objectives: In multitransfused thalassaemic patients, haemagglutination fails to phenotype the patient's blood group antigens due to the presence of donor-derived erythrocytes. DNA-based methods can overcome the limitations of haemagglutination and can be used to determine the correct antigen profile of these patients. This will facilitate the procurement of antigen-matched blood for transfusion to multitransfused patients. Thus, the aim of this study was to compare the serological phenotyping of common and clinically important antigens of Rh, Duffy, Kell, Kidd and MNS blood group systems with molecular genotyping amongst multitransfused thalassaemic patients. Methods: Blood samples from 200 patients with thalassaemia and 100 ‘O’ group regular blood donors were tested using standard serological techniques and polymerase chain reaction-based methods for common antigens/alleles (C, c, D, E, e, Fy a , Fy b , Jk a , Jk b , K, k, M, N, S, s). Results: Genotyping and phenotyping results were discordant in 77 per cent of thalassaemic patients for five pairs of antithetical antigens of Rh, Duffy, Kell and Kidd blood group systems. In the MNS blood group system, 59.1 per cent of patients showed discrepancy. The rate of alloimmunization among thalassaemics was 7.5 per cent. Interpretation & conclusions: Molecular genotyping enabled the determination of the actual antigen profile in multitransfused thalassaemia patients. This would help reduce the problem of alloimmunization in such patients and would also aid in the better management of transfusion therapy.

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Section: Discussionsupporting

confidence: 90%

Molecular genotyping of clinically important blood group antigens in patients with thalassaemia

Kulkarni¹,

Choudhary²,

Gogri³

et al. 2018

Indian J Med Res

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“…This was comparable to the study by Pathak S et al 10 which reported an overall rate of alloimmunisation of 1.5% in 45,373 patients. These frequencies were low as compared to 2.71% in 4569 patients and 5.5% in 200 patients reported by Agarwal A et al 12 and Philip J et al 13 Therefore, the reported prevalence of alloimmunisation in multi-transfused patients in India varies from approximately 3% to 10%. 14,15,16 The rate of alloimmunisation globally was variable with 1.35% in Denmark, 17 0.78% in Germany, 18 and 0.3-2% in the USA 19,20 to 21.1% in Greece, 21 30% in Kuwait 22 and 37% in Taiwan.…”

Section: Discussionmentioning

confidence: 67%

Comparison Between Conventional Tube Technique and Column Agglutination Technique for Antibody Screening and Identification at MGM Blood Bank, Navi Mumbai

Varshney¹,

Gupta²

2017

jemds

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BACKGROUND Pretransfusion testing is one of the most important section of the entire transfusion process. Conventional tube technique (CTT) is the most commonly employed technique in blood grouping, cross-matching and for the detection of antibodies. It is still considered as a gold standard in the pretransfusion testing but it has some inherent limitations. Newer techniques have been introduced to overcome the shortcomings of the CTT. One of them is Column agglutination technique (CAT). The present study was aimed to evaluate the efficacy in terms of sensitivity and specificity of CAT over the CTT in our setup for antibody screening and identification. MATERIALS AND METHODS The prospective comparative study was conducted for a period of 6 months. A total of 2258 patients' samples were screened for antibody detection during the pretransfusion testing process. Each sample was tested with CTT parallelly with CAT for antibody screening and identification. The results of CTT and CAT were compared using Student 't' test, p value of <0.05 was considered significant. The sensitivity and specificity were calculated by the standard manual method. RESULTS Out of 2258 samples screened, a total of 11 cases with antibodies were identified. Of these, all 11 could be identified by CAT and only 7 were determined by CTT. The overall incidence of alloimmunisation was 0.5%. Out of 11 antibodies, 10 were clinically significant and one was clinically insignificant. The most commonly found antibody was Anti-D followed by Anti-c, Anti-M, Anti-Fy(a) and Anti-Le(a). The results obtained by CTT and CAT showed statistical significant difference, p value=0.04. The sensitivity of CTT was 63.63% while the specificity was 100%. The sensitivity and specificity of CAT were 100%. CONCLUSION The gel technique is now considered better and has been introduced as a replacement to conventional tube technique on an automation platform. Though CTT is still considered gold standard in pretransfusion testing, it still has various disadvantages and depends on accurate hand to eye work of the laboratory personnel. The CAT, although being costly affair, still has several advantages over the tube technique. Therefore, it is highly recommended to be used routinely in the pretransfusion testing.

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“…The risk of alloimmunization is higher in patients who have received multiple blood transfusions such as patients of thalassemia and other hemoglobinopathies, hematological disorders, renal failure on dialysis and females with bad obstetric history [Table 6]. [78]…”

Section: Discussionmentioning

confidence: 99%

“…Different studies in general patients have estimated the presence of unexpected alloantibodies against red cell antigens between 0.46% and 2.4%, while studies in multitransfused patients has reported higher frequency for unexpected alloantibodies. [7]…”

Section: Discussionmentioning

confidence: 99%

Antibody screening and identification in donors and general patients at a tertiary care teaching hospital in Western India

Gupta¹,

Gajjar²,

Patel³

et al. 2019

Asian J Transfus Sci

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BACKGROUND AND OBJECTIVES: The aim of the blood transfusion service should be to provide effective blood and blood components, which are as safe as possible and adequate to meet patient's need. To achieve safe blood transfusion practice, many blood transfusion center in India follow routine type and screen protocol for all patient's and donor's blood samples to detect unexpected alloantibodies. The present study is aimed at assessing the frequency and type of unexpected red cell alloantibodies in general patient population and donors at a tertiary care teaching hospital in western India. MATERIALS AND METHODS: In this prospective study, samples of patients as well as blood donors were processed for ABO and Rh “D” grouping as well as antibody screening with three cell screening panel on fully automated immunohematology analyzer. Positive sample in three cell screening panel was further evaluated for identification of specific alloantibody with eleven cell identification panel by column agglutination technique. Results were recorded, and data were analyzed to calculate the frequency of unexpected alloantibody. RESULTS: A total of 74,214 patient samples and 80,173 donor samples were processed for type and screen. Out of which, 512 patients and 11 donors were identified with alloantibody. Most common alloantibody found in the present study is anti-D (0.075%), followed by anti-E (0.041%), anti-c (0.021%), anti-K (0.0205%) in Rh and Kell blood group system. CONCLUSION: Antibody screening and identification of specific alloantibody help in identifying most appropriate blood unit that lacks the corresponding antigen and prevent alloimmunization.

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Red Blood Cell Alloimmunization in Multi - transfused Patients: A Bicentric Study in India

Cited by 21 publications

References 0 publications

Molecular genotyping of clinically important blood group antigens in patients with thalassaemia

Molecular genotyping of clinically important blood group antigens in patients with thalassaemia

Comparison Between Conventional Tube Technique and Column Agglutination Technique for Antibody Screening and Identification at MGM Blood Bank, Navi Mumbai

Antibody screening and identification in donors and general patients at a tertiary care teaching hospital in Western India

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