Abstract
Background. Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. Data about alloimmunization rate in general patient population is scarce especially from resource limited countries. We undertook this study to determine prevalence and specificity of RBC alloantibodies in patients admitted in various clinical specialties at a tertiary care hospital in North India. Methods. Antibody screening was carried out in 11,235 patients on automated QWALYS 3 platform (Diagast, Loos, France). Antibody identification was carried out with an 11-cell identification panel (ID-Diapanel, Diamed GmbH, Switzerland). Results. The overall incidence of RBC alloimmunization in transfused patients was 1.4% (157/11235), with anti-E being the most common specificity (36.3%), followed by anti-D (16%), anti-c (6.4%), anti-c + E (6.4%), anti-C + D (5.1%), and anti-K (4.5%). The highest incidence of alloimmunization was observed in hematology/oncology patients (1.9%), whereas in other specialties the range was 0.7–1%. Conclusion. As alloimmunization complicates the transfusion outcomes, authors recommend pretransfusion antibody screening and issue of Rh and Kell matched blood to patients who warrant high transfusion requirements in future.
Highlights
Red blood cell (RBC) transfusion is a lifesaving therapy for complications of anemia and treatment of the symptoms and signs of hypoxia
Current standard pretransfusion testing protocols require detection and identification of clinically significant antibodies reacting in antihuman globulin (AHG) phase after incubation at 37∘C
The overall alloimmunization rate was 1.4% which was low when compared with a study done by Hematology/oncology Gynecology Orthopedics Nephrology/urology Gastroenterology/gastrosurgery Others Total
Summary
Red blood cell (RBC) transfusion is a lifesaving therapy for complications of anemia and treatment of the symptoms and signs of hypoxia. Except identical twins, have the same genetic makeup, blood transfusion exposes the patient to numerous “foreign” antigens. These foreign antigens are potential immunogens which can lead to development of antibodies in the recipient within days, weeks, or months after a transfusion [2]. Risk of alloimmunization can be significantly decreased by typing the donors’ and patients’ clinically significant antigens. This extended matching would be an ultimate solution, the associated costs and logistics will raise serious concerns especially in resource limited countries [3]. Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. As alloimmunization complicates the transfusion outcomes, authors recommend pretransfusion antibody screening and issue of Rh and Kell matched blood to patients who warrant high transfusion requirements in future
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