Abstract
Abstract This report is part of a series reporting the proceedings from the International Society of Blood Transfusion (ISBT) Working Party on Immunohaematology Workshop on the Clinical Significance of Red Blood Cell Alloantibodies. The aim of the workshop was to review information regarding the clinical significance of alloantibodies to red blood cell antigens recognized by the ISBT. The first 12 systems will be covered in this report. It is understandable that many of the most clinically important antibodies are directed toward antigens found in the blood group systems discovered earlier in history. The ABO system was the first to be discovered and remains the most clinically important regarding transfusion.
Highlights
The International Society of Blood Transfusion (ISBT) currently recognizes 36 blood group systems, which contain a total of 322 antigens.[1]
Despite consisting of just four polymorphic antigens—A, B, A,B, and A1—the genetics and carbohydrate chemistry underpinning the expression of these antigens is complex.[6]. Because these antigens are abundant on red blood cell (RBC) and because most adults have “naturally occurring” antibodies to the antigens that they lack, ABO antibodies are clinically significant; anti-A, -B, and -A,B cause severe intravascular hemolytic transfusion reactions (HTRs)
Data compiled from the International Society of Blood Transfusion (ISBT).[1] are present on tissues and within secretions of the fetus, preventing the antibodies from binding to the fetal RBCs
Summary
The ABO blood group system was the first to be discovered and is still the most clinically important. Despite consisting of just four polymorphic antigens—A, B, A,B, and A1—the genetics and carbohydrate chemistry underpinning the expression of these antigens is complex.[6] Because these antigens are abundant on RBCs and because most adults have “naturally occurring” antibodies to the antigens that they lack, ABO antibodies are clinically significant; anti-A, -B, and -A,B cause severe intravascular hemolytic transfusion reactions (HTRs). Donor RBCs lacking the antigens corresponding to the antibodies in the recipient’s plasma (i.e., ABO compatible) must be selected for transfusion. The donor ABO blood group must be considered when transfusing plasma components because of the presence of ABO antibodies in all but group AB donors. If group-specific plasma components are not available, the use of components known to be negative for the presence of high-titer ABO antibodies should be considered. Despite clinical significance in transfusion, hemolytic disease of the fetus and newborn (HDFN) due to ABO antibodies is rare.
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