Detection of alloimmunization to ensure safer transfusion practice

Abstract

Background:Serological safety is an integral part of overall safety for blood banks. Emphasis is on the use of routinue Red Blood Cell (RBC) antibody screen test, at set time intervals, to reduce risks related to alloantibodies. Also emphasis is on importance of issuing antigen negative blood to alloantibody positive patients. Effect of using leucodepleted blood on the rate of alloimmunization is highlighted. The concept of provision of phenotypically matched blood is suggested.Materials and Methods:Antibody screen test is important to select appropriate blood for transfusion. Repeat antibody screen testing, except if time interval between the earlier and subsequent transfusion was less than 72 hours, followed by antibody identification, if required, was performed in patients being treated with repeat multiple blood transfusions. Between February 2008 and June 2009, repeat samples of 306 multi-transfused patients were analyzed. Search for irregular antibodies and reading of results was conducted using RBC panels (three-cell panel of Column Agglutination Technology (CAT) and two cell panel of the Solid Phase Red Cell Adherence Technology (SPRCAT). Specificities of antibodies were investigated using appropriate panels, 11 cell panel of CAT and 16 cell panel of SPRCA. These technologies, detecting agglutination in columns and reactions in solid phase, evaluate the attachment of irregular incomplete antibody to antigen in the first phase of immunological reaction more directly and hence improve the reading of agglutination. Three to four log leuco reduced red blood cells were transfused to patients in the study using blood collection bags with integral filters.Results:Alloimmunization rate of 4.24% was detected from 306 multiply transfused patients tested and followed up. The Transfusion therapy may become significantly complicated.Conclusion:Red cell antibody screening and identification and subsequent issue of antigen negative blood have a significant role in improving blood safety. Centers that have incorporated antibody screen test and identification have ensured safe transfusion. Identified patients should be flagged in a database and information shared. Such patients can be given carry-on cards and educated about the names of the identified antibodies. Full red cell phenotyping of individuals, patients and donors, can be feasibility.

Human leucocyte antigen alloimmunisation in repeatedly transfused thalassemic Egyptian children and its relation to febrile non‐haemolytic transfusion reactions

“…Regarding the frequency of transfusions in the LCA positive and negative groups, there was no statistical significant difference ( p = 0·362) between both groups which means that this factor is also mostly not related to HLA alloimmunisation. Sood et al () who aimed at detecting alloimmunisation, to ensure safe practice for thalassemic patients, confirmed our results by observing that the risk of developing alloimmunisation was not associated with the number or frequency of transfusions received.…”

Effect of red blood cell preservation by droplet freezing with non‐permeable cryoprotective agents in blood group antigen reactivity

“…The accurate screening and identification of RBC antibodies is necessary to identify alloimmunized patients and to find compatible blood units (Sood et al ., ). The classical method for antibody screening and identification is haemagglutination using the indirect antiglobulin test (IAT), which is commonly performed with a red cell panel (AABB).…”

Investigation of Red Cell Antiobody Screening Tests Gyeonggi Areas

“…To avoid the effects of alloimmunization, routine RBC antibody screening at set time intervals after transfusion i.e. repeat antibody screens of the patient if the time interval between two transfusions is more than 72 hours, should be ensured[14].…”