Uloga Kidd-antitela u posttransfuzijskim reakcijama

Ljubinka Nikolić,Tatjana Ilić-Mostić,Srđan Marković,Saša Kadija,Gradimir Bogdanović,Nenad Mladenović,Tanja Stričević,Emina Čolak,Dragana Kastratović

doi:10.5937/hpimj1902794n

Ljubinka Nikolić, Tatjana Ilić-Mostić + Show 7 more

Open Access

https://doi.org/10.5937/hpimj1902794n

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Abstract

Topic: The Kidd blood group (Jk) was discovered in 1951 and according to International Society for blood transfusion (ISBT) the Kidd (Jk) blood group is registered under the number 009. Antigens of the Kidd system are detected only on RBCs and kidney. Incompatibile transfusion in Jk blood group can provoke sensitization and appearance of anti-Jka or anti-Jkb antibodies. Jk antibodies are common cause of delayed hemolytic transfusion reactions (DHTRs). Although Kidd antibodies can lead to acute reactions, kidney damage and hemoglobinuria are very rare. More important is Kidd-antibody ability for delayed hemolytic reactions. The aim is to underline Jka antibodies laboratory characteristics, their role in delayed posttransfusion reactions and possible complications of blood transfusions. The topic position in scientifi c/professional public: Kidd-antibodies, usually, destroy transfused red cells after a variable period of between 7 and 21 days. DHTR is the result of anti-Jka antibodies tendency to fall rapidly to undetectable levels even after incompatible transfusion. Anti-Jka has been reported as reason for kidney transplant rejection. There were examples of anti-Jka that react only when preservatives such as p-hydroxybenzoic acid (parabens), Na-azide or related compounds, antibiotics are present in the reaction mixture. Also, patient's therapy with antibiotics and monoclonal antibodies could cause false positive RBC antibody. Further action needed for better topic covering in future: Except in life threatening condition, reduction of allogenic blood transfusion is recommended. Increase the number of autologous transfusions in all cases when the patient's clinical condition allows. Antigen-free RBC ie universal RBC would be the best choice for transfusion. It is essential to perform extended erythrocyte phenotyping prior to initiation of monoclonal antibodies therapy. As a minimum blood typing for Rh, K, Jka,Jkb, Fya, Fyb and Ss antigens should be done for every patient who is planned to be treated with monoclonal antibodies.Overcoming this problem is very important for patients who are transfusion-dependent or candidates for monoclonal antibody therapy, or candidates for kidney transplantation.

Highlights

The Kidd blood group (Jk) was discovered in 1951 and according to International Society for blood transfusion (ISBT) the Kidd (Jk) blood group is registered under the number 009
In patient noncompliant with immunosuppressive regimes, acute graft rejection occurred simultaneously with the occurrence of a Kidd antibodies [20,21]. Overcoming this problem is very important for patients who are transfusion-dependent or candidates for monoclonal antibody therapy, or candidates for kidney transplantation [22,23]
Antigen-free RBC ie universal RBC would be the best choice for transfusion, and using specific monoclonal antibodies would be the therapeutic choice in patients who are sensitive to erythrocyte antigens [37,38]

Summary

SUMMARY

Topic: The Kidd blood group (Jk) was discovered in 1951 and according to International Society for blood transfusion (ISBT) the Kidd (Jk) blood group is registered under the number 009. Antibiotics used for classic patient therapy and antibiotics added to blood groups reagents for immunohematological transfusion testing could be false positive to RBC antibodies [34] The most frequent antibiotics used as a preservative in diluents for commercial RBCs reagents, such as chloramphenicol, neomycin sulfate, co-trimoxazole, and gentamycin could cause false positive RBC antibodies (Ab) [26,35] In these cases of false positive RBC Ab there were no clinical or laboratory evidence of hemolysis [5,18,26,34,36]. Antigen-free RBC ie universal RBC would be the best choice for transfusion, and using specific monoclonal antibodies would be the therapeutic choice in patients who are sensitive to erythrocyte antigens [37,38] It is recommended, prior to initiate monoclonal antibody therapy, along with baseline ABO, RhD, DAT and IAT, to perform extended RBC phenotype: Rh, MNSs, Kell, Kidd and Duffy blood group systems. Data exchange among world-renowned experts would make this problem more understandable and easier to fix [43,44,45]

FURTHER ACTION NEEDED FOR BETTER TOPIC COVERING IN FUTURE

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