Red Blood Cell Alloimmunization in Patients Requiring Transfusion

Background:Red blood cell (RBC) alloimmunization in the general population is reported to occur after transfusion of less than 1 to 3 percent. However, in multitransfused patients is reported to occur at an incidence of 5.2% to 23.5%. With very limited data on alloimmunization among the Yazd population, a study has been conducted to determine its frequency among patients referred from health care centers to Yazd Blood Transfusion Center.Methods:A retrospective study was conducted from 2013 to 2017. Demographic information and serologic data for patients requiring transfusion referred from health care centers of Yazd were retrieved for analysis. Antibody screening and identification tests results were investigated.Results:A total of 347 patients were identified and consisted of 157 males and 190 females with an age range of 1 to 90 years. 104 cases (30.0%) were reported to have RBC antibodies. Of them, 67 alloantibodies, 37 autoantibodies, and 3 unidentified antibodies were identified. Anti-M (16, 15.4%), anti-D (14, 13.5%), anti-C (14, 13.5%), anti-E (10, 9.6%), anti-K (9, 8.6%) and anti-c (8, 7.7%) were the most frequent antibodies reported. Two cases of rare alloantibodies (anti-P and anti-PP1Pk) were defined. Eighteen patients (17.3%) had multiple alloantibodies. Conclusions:Clinically significant alloantibodies against Rh, Kell and M blood group antigens are common. For decreasing the risk for RBC alloimmunization, patients should be given corresponding antigen negative blood unit; therefore extended donor and patients RBC antigen phenotyping is recommended.

Keywords:

Transfusion , alloantibody , red blood cells