Transfusion in autoimmune hemolytic anemia: comparison of two different strategies

Abstract

Objective: Autoimmune Hemolytic Anaemia (AIHA) is a condition in which red blood cells (RBC) are destroyed by autoantibodies. Clinicians tend to avoid the transfusion in AIHA patients who has difficulties during pre-transfusional testing. Depending on the institutional policy, the transfusion of the selected least incompatible RBC unit is a strategy. Since ORh(-) RBCs are the universal RBC donor type, the transfusion of the group ORh(-) RBC is selected in AIHA patients. In this study, we compared the effects of group ORh(-) RBC or least match incompatible same type of blood product transfusion in AIHA patients.
 Material and Methods: The study included newly-diagnosed AIHA patients without active bleeding who required transfusion due to symptomatic anemia. ORh(-) RBC was transfused to the patients who had different blood groups and for the other patients, the least match incompatible same type blood product was transfused. Pre- and post-transfusion hematological and biochemical indicators were reported and compared.
 Results: We determined that; there was no significant difference between groups regarding the increase in Hb levels and hemolysis parameters. In correlation analysis, the lower the pre-transfusion MCV value, the higher the LDH change. The lower the pre-transfusion MCV value, the decrease in hemolysis was higher.
 Conclusion: Clinicians should not avoid transfusion for critically anemic AIHA patients for whom compatible RBC has not been found. Both group ORh(-) types of RBCs and same type least incompatible RBCs can be preferred for transfusion in critically patients when further compatibility testing procedures for alloantibodies detection cannot be performed.