A case for a national registry of red blood cell antibodies

Abstract

Background and Objectives: Red blood cell (RBC) antibody levels diminish over time and negative antibody screen are commonly seen in patients with a history of antibodies. Most hospitals do not have access to a shared registry of antibodies previously detected at other hospitals. Materials and Methods:We describe a case where the patient was found to be at high risk of bleeding during liver transplantation. Antibody screen on admission was negative but a history of anti-Jk a was identified on reviewing patient's history in local registry of RBC antibodies. The surgery was pushed back to arrange for antigennegative units. The patient received a total of 16 Jk(aÀ) RBC units during the admission.Results: No acute or delayed transfusion adverse reactions were seen. However, if the history of anti-Jk a identified at another local hospital was not known, approximately three-quarters of the units transfused would have been Jk(a+). Transfusing Jk(a+) units could have potentially exposed the patient to risk of developing an acute and/or delayed haemolytic transfusion reaction which could have led to significant morbidity and perhaps mortality. Conclusion:With this case report, we build a case for developing a national registry of RBC antibodies to help improve patient safety and outcomes. K E Y W O R D S blood safety, RBC antigens and antibodies, serological testing, transfusion reactions Highlights • Most hospitals do not have access to a shared registry of RBC antibodies previously detected at other hospitals.