Author(s): Thakral B, Saluja K, Sharma RR, Marwaha N
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Abstract BACKGROUND: Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. There is a paucity of data on the incidence of RBC alloimmunization in transfused recipients from the region studied, as pre-transfusion antibody screening is not routinely performed. AIM: To assess the incidence of RBC alloimmunization in a transfused patient population at a tertiary care hospital in north India. MATERIALS AND METHODS: Antibody screening was carried out in 531 multi-transfused patients prior to crossmatching with a commercially available three-cell panel (Diacell; Diamed AG, Cressier-sur-Morat, Switzerland) by the tube method, using a saline indirect antiglobulin test. Antibody screen-positive samples were analyzed for the specificity of the alloantibody with an 11-cell identification panel (Diapanel; Diamed AG). Antigen-negative crossmatch-compatible blood was transfused if the antibody was clinically significant, whereas for clinically insignificant antibodies, crossmatch-compatible blood at anti-human globulin phase was issued for transfusion. RESULTS: The overall incidence of RBC alloimmunization in transfused patients was 3.4\% (18/531), with anti-c being the most common specificity (38.8\%), followed by anti-E (22.2\%), anti-M (11.1\%), anti-Le(a) (11.1\%), anti-D (5.6\%), anti-Jk(a) (5.6\%) and anti-Le(b) (5.6\%). The highest incidence of alloimmunization was observed in gastroenterology patients (4.5\%), followed by hematology patients (3.5\%). Of the antibodies detected, 16.7\% (3/18) were clinically insignificant with Le(a), Le(b) and M specificities. CONCLUSIONS: The majority of alloantibodies detected in the current study were clinically significant. Thus, pre-transfusion antibody screening on patients' samples prior to crossmatching needs to be initiated in India to ensure safe transfusion practice.
This article was published in Hematology
and referenced in Journal of Blood Disorders & Transfusion