The importance of antibodies against low‐incidence RBC antigens in complete and abbreviated cross‐matching

Schonewille, Henk; Zijl, Annette M. Van; Wijermans, Pierre W.

doi:10.1046/j.1537-2995.2003.t01-1-00435.x

Cited by 21 publications

(19 citation statements)

References 25 publications

(42 reference statements)

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“…According to Schonewille et al, the prevalence of LIA-Ab varied between 0.3% and 10% and they found no anti-Di a . Anti-Wr a was the most frequent antibody found in this study (14) .…”

Section: Discussionsupporting

confidence: 52%

“…These findings differ from those found by Schonewille et al regarding alloimmunization to the Fy a antigen. A prevalence of 1% of anti-Fy a was found while these authors reported 7.3% of anti-Duffy in their study (14) . Twenty patients (8.8%) developed multiple antibodies.…”

Section: Discussionmentioning

confidence: 63%

“…Only three patients showed hemolysis, one of which was an anti-Jk a case (13) . Schonewille et al found 2.8% of anti-Kidd in 1,795 patients with 2,257 antibodies (14) . These findings differ from those found by Schonewille et al regarding alloimmunization to the Fy a antigen.…”

Section: Discussionmentioning

confidence: 97%

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Prevalence of erythrocyte alloimmunization in polytransfused patients

Cruz

Mota

Conti

et al. 2011

Einstein (São Paulo)

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Objective: To determine the incidence and the rate of red blood cell alloimmunization in polytransfused patients. Methods: A polytransfused patient was defined as having received at least 6 units of red cell concentrates during a 3-month period. The records of all patients (n = 12,904) who had received red blood cell units were examined retrospectively by searching the computer database at Hospital Israelita Albert Einstein in São Paulo, Brazil, over a 6-year period, between 2003 and 2009. results: During this time, 77,049 red cell concentrate transfusions were performed in 12,904 patients. There were 3,044 polytransfused patients, 227 of whom (7.5%) presented with irregular erythrocyte antibodies. The prevalence of alloantibody specificity was: Anti-E>anti-D>anti-K>anti-C>anti-Di a >anti-c>anti-Jk a >anti-S in 227 polytransfused patients. We found combinations of alloantibodies in 79 patients (34.8%), and the most common specificities were against the Rh and/or Kell systems. These antibodies show clinical significance, as they can cause delayed hemolytic transfusion reactions and perinatal hemolytic disease. About 20% of the patients showed an IgG autoantibody isolated or combined with alloantibodies. Interestingly, a high incidence of antibodies against low frequency antigens was detected in this study, mainly anti-Di a . conclusion: Polytransfused patients have a high probability of developing alloantibodies whether alone or combined with autoantibodies and antibodies against low frequency antigens. Transfusion of red blood cells with a phenotype-compatible with RH (C, E, c), K, Fy a , and Jk a antigens is recommended for polytransfused patients in order to prevent alloimmunization and hemolytic transfusion reactions.

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“…According to Schonewille et al, the prevalence of LIA-Ab varied between 0.3% and 10% and they found no anti-Di a . Anti-Wr a was the most frequent antibody found in this study (14) .…”

Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 63%

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Prevalence of erythrocyte alloimmunization in polytransfused patients

Cruz

Mota

Conti

et al. 2011

Einstein (São Paulo)

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“…In this issue of TRANSFUSION , Schonewille et al 26 add to the European experience by reviewing data from their hospital from 1978 to 2000; complete crossmatches were performed before 1991. They were particularly interested in abLIA that might appear in patients who had already made other alloantibodies.…”

Section: Incidence Of Antibodies Of Potential Clinical Significancementioning

confidence: 99%

How concerned should we be about missing antibodies to low incidence antigens?

Garratty¹

2003

Transfusion

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“…However, its corresponding antibody is much more prevalent. The prevalence of anti-Wr a is ranging from 1:56 in healthy blood donors [3] to 5.8% in a range of individuals (blood donors, pregnant women, and hospitalized patients) [4]. Anti-Wr a is capable of causing severe hemolytic transfusion reactions (HTRs) [5] as well as hemolytic disease of the newborn [6], but because of the low frequency of Wr a antigen severe reactions are relatively uncommon.…”

Section: Introductionmentioning

confidence: 99%

Fatal Acute Hemolytic Transfusion Reaction due to Anti-Wra

Bahri

Bruyn

Leys

et al. 2018

Transfus Med Hemother

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Background: The Wr^a blood group antigen is a low-frequency antigen. Antibody screening sets used in pretransfusion laboratory investigations usually do not contain a Wr(a+) cell. If subsequent cross-matching is performed without indirect antiglobulin test (IAT), Wr^a antibodies reacting with donor red blood cells (RBCs) will be missed. For reasonable economic and time-saving arguments the risk of missing the detection of a potential clinically relevant antibody is worldwide accepted. Case Report: A 66-year-old women with a negative antibody screen rapidly deteriorated after she received two units of RBCs for symptomatic anemia after hip surgery. Diagnosis of a transfusion reaction was obscured by pre-existing and nonspecific symptoms. Laboratory investigation indicated acute hemolysis. Cross-matching in IAT was positive for the first unit, and an extended antibody identification panel showed reactivity with Wr(a+) cells. The patient did not respond to supportive therapy and died within 48 h after the start of transfusion. Conclusion: This dramatic case provides further evidence on the clinical relevance of Wr^a blood group antibodies. In addition, it underlines the clinical importance of risk awareness in the blood transfusion chain and the possible complexity in relation to patient monitoring in daily transfusion practice.

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The importance of antibodies against low‐incidence RBC antigens in complete and abbreviated cross‐matching

Cited by 21 publications

References 25 publications

Prevalence of erythrocyte alloimmunization in polytransfused patients

Prevalence of erythrocyte alloimmunization in polytransfused patients

How concerned should we be about missing antibodies to low incidence antigens?

Fatal Acute Hemolytic Transfusion Reaction due to Anti-Wra

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