Safety assessment of RhD-positive red cell transfusion in RhD-negative liver-transplant recipients: Single-centre report from India

Tiwari, Aseem Kumar; Arora, Dinesh; Aggarwal, Geet; Dara, Ravi C; Bhardwaj, Gunjan; Sharma, Jyoti; Vohra, Vijay; Soin, Arvinder S.

doi:10.4103/ijmr.ijmr_315_19

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“…Two patients showed weak and transient anti‐D reacting only with papain‐treated RBCs at 10 and 11 days without any signs of haemolysis. Other investigators also have supported the safety of transfusing D‐positive RBCs in D‐negative patients during OLT surgery [5, 6, 18]. Table 2 summarizes the studies that evaluated alloimmunization to the D antigen in D‐negative OLT recipients who were transfused with D‐positive blood.…”

Section: Discussionmentioning

confidence: 99%

Lack of alloimmunization to the D antigen in D‐negative orthotopic liver transplant recipients receiving D‐positive red blood cells perioperatively

et al. 2022

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Background and Objectives D‐negative patients undergoing orthotopic liver transplantation (OLT) might require a large number of red blood cell (RBC) units, which can impact the inventory of D‐negative blood. The blood bank might need to supply these patients with D‐positive RBCs because of inventory constraints. This study evaluates the prevalence of anti‐D formation in D‐negative OLT patients who received D‐positive RBCs perioperatively, as this will assist in successful patient blood management. Materials and Methods This was a retrospective study performed at a single academic medical centre. Electronic medical records for all 1052 consecutive patients who underwent OLT from January 2007 through December 2017 were reviewed. D‐negative patients who were transfused perioperatively with D‐positive RBCs and had antibody screening at least 30 days after transfusion were included. Results Of a total of 155 D‐negative patients, 23 (14.8%) received D‐positive RBCs perioperatively. Seventeen patients were included in the study. The median age was 54 years (range 36–67 years); 13 (76.5%) were male. The median number of D‐positive RBC units transfused perioperatively was 7 (range 1–66 units). There was no evidence of D alloimmunization in any patient after a median serologic follow‐up of 49.5 months (range 31 days to 127.7 months). The average number of antibody screening post OLT was 7.29. Conclusion Our study showed that transfusion of D‐positive RBCs in D‐negative OLT recipients is a safe and acceptable practice in the setting of immunosuppression. This practice allows the conservation of D‐negative RBC inventory.

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Section: Discussionmentioning

confidence: 99%