Determination and Successful Transfusion of Anti-Gerbich-Positive Red Blood Cells in a Patient with a Strongly Reactive Anti-Gerbich Antibody

Abstract

Background: The clinical relevance of antibodies directed against members of the Gerbich (GE) family of antigens is not invariably clear. Given the scarcity of serologically compatible red blood cells (RBC), various methods may have to be applied to assess the safety of transfusing serologically incompatible RBC. Patient and Methods: The serum of a 57-year-old male Caucasian admitted to hospital for gastrectomy was found to contain a highly reactive anti-GE2 antibody (IgG₁). In addition to a monocyte monolayer assay, 50 ml of GE2-positive RBC were transfused, and blood samples were taken before and 1 and 24 h after transfusion for flow-cytometric determination of transfused cells. Results: Both tests showed no increased destruction of GE2-positive RBC. The transfusion of 4 units of GE2-positive RBC was well tolerated, and hemoglobin increased adequately. Conclusion: This case may extend the information available not only on antibodies directed against members of the GE family of antigens but also on methods to estimate the survival of transfused RBC.

Successful transfusion of antigen positive blood to alloimmunised patients using a monocyte monolayer assay

“…Numerous examples of alloimmunised patients, successfully transfused with antigen positive blood, following an in vitro crossmatch are described in the literature (Eckrich et al , ; Kelley et al , ; Hildebrandt et al , ; Yuan et al , , ). However, the first systematic correlation between an in vitro test, and post‐transfusion outcome was published by Schanfield et al ().…”

The First Korean Case Report of Anti-Gerbich

“…Reactivity can be lost when papain-treated RBCs are reacted with a patient's serum that has anti-Ge2, and hemolytic transfusion reactions could occur when a person who has anti-Ge2 receives a RBC transfusion from an incompatible blood type, although this is controversial [3]. There have also been some reports of cases where a patient has shown tolerance after a transfusion [5-7]. Anti-Ge3 is detected from the Ge and Leach types but not the Yus type, and it is known to react with antigens from GPC and GPD and induce hemolysis [3].…”

A mild acute hemolytic transfusion reaction in a patient with alloanti‐Ge3: a case report and review of the literature

“…Nineteen cases of “clinically insignificant” anti‐Gerbich were also found, and in five of these cases patients were transfused units of Ge+ blood that were tolerated well (Table 4). 6‐11 …”

“…Anti‐Gerbich autoantibody has also been reported in cases of autoimmune hemolytic anemia 4,5 . However, in the available English literature, there has been no well‐documented case of an acute hemolytic transfusion reaction (HTR) due to Gerbich alloantibodies 6‐18 . We report here the case of a patient with anti‐Ge3 who initially responded well to several units of Ge+ RBCs, but later suffered a transfusion reaction to Ge+ units.…”