Transfusion management of patients with red blood cell antibodies

Abstract

Red blood cell antibodies may cause a positive result of pre-transfusion blood compatibility testing (crossmatch test). It can be a problem to provide suitable blood units for patients with clinically significant antibodies to high-frequency antigens as well as for those with multiple alloantibody specificities. This study was aimed at identifying transfused patients in the population of South-Backa who had developed clinically significant red blood cell alloantibodies. We analyzed the records of crossmatch results and antibody screening performed at the Blood Transfusion Institute of Vojvodina during 2012. Antibodies were found in 103 patients: A) 63 patients with single antibodies: 1) 16 with antibodies of unknown specificity (3 autoantibodies, 13 alloantibodies); 2) 39 with clinically significant antibodies (23 from Rh system (2 anti-C, 2 anti-D, 12 anti-E, 7 anti-c), 4 anti-K, 3 anti-Fya, 7 anti-Jka, 2 anti-S); 3) 8 with usually not significant antibodies (6 anti-M, 1 anti-Al, 1 antiC); B) 40 patients developed multiple antibodies: 1) all patients had at least one clinically significant antibody from various blood group system (44 Rh, 13 Kell, 7 Kidd, 7 MNSs (S, s)); 2) 3 patients had usually not significant antibodies (1 Lewis, 2 Lutheran); 3) 3 patients occasionally had clinically significant antibody (3 anti-Ytd4) 3 patients had antibodies of unknown specificity (2 autoantibodies, lalloantibody). Antibodies detected in the majority of patients (65-63.1%) had a specificity of Rh and/or the Kell system. The main goal of pre-transfusion blood compatibility testing is to detect clinically significant antibodies. The provision of antigen negative blood units for those patients is a special challenge for blood establishments. Database with a sufficient number of typed blood donors can help to resolve this problem.