Erythrocyte Alloimmunization and Autoimmunization among Blood Donors and Recipients visiting a Tertiary Care Hospital

Abstract

Introduction: The ultimate aim of pretransfusion testing is the acceptable survival of donor red cells in recipient's body and antibody detection plays a critical role in achieving the same. The cornerstone of antibody detection method is detecting an unexpected antibody as against the expected antibodies of ABO blood group system. Autoantibodies can also interfere with the detection of clinically significant alloantibodies. Aim:To study the frequency of alloantibodies and autoantibodies in the healthy blood donors and patient population visiting our hospital. Materials and Methods:The Column Agglutination Technology (CAT) was used for ABO RhD blood grouping, Direct Antiglobulin Test (DAT), Autocontrol (AC), Indirect Antiglobulin Test (IAT) and red cell antibody screening and the unexpected reactions in any of these tests were recorded for further evaluation. Ethylene Diamine Tetra Acetic Acid (EDTA) blood samples were used for all these tests for both blood donors and admitted patients. The CAT was exercised for the blood grouping (using ABDReverse Diluent cassettes) and antibody screening (using 0. Results: Among all blood donors (n=6350), seven (0.11%) donors had showed unexpected reaction. Of these, four had positive antibody screen (three having naturally occuring antibodies 2=anti-M, 1=anti-Le a and 1=inconclusive) and the other three had positive DAT. Of all the patient samples (n=6136) screened for irregular red cell antibodies, four (0.06%) patients were found to have unexpected reaction revealing one (0.02%) with anti-M antibody and the other three (0.05%) had autoantibodies in their serum. Conclusion:The combined prevalence for both blood donor and recipient population (n=12,486) was found to be 0.11% at our center. The alloimmunisation among patient population was found to be lower than many other studies worldwide as our hospital does not cater to multitransfused or transfusion dependant patients with haematological disorders and majorly elective surgery patients with no history of previous blood transfusions visit our hospital.www.jcdr.net Daljit Kaur et al., Erythrocyte Alloimmunization and Autoimmunization among Blood Donors and Recipients

Prevalence of red blood cell antibodies in whole blood donors

“…A study conducted in Southern Thai population 8 showed the following antibodies, frequency-wise as most common - anti-Mi a , anti-E, anti-Le a , anti-c and anti-Le b . In the present study, only 30 donors (0.018%) had autoantibody as also reported earlier by Kaur et al (0.5%) 6 and Tiwari et al (0.04%) 18 . In the present study, though we took detailed history about the aetiology of antibody formation, many alloantibodies were found in male blood donors.…”

“…The higher rate of alloimmunization in females could be attributed to antigenic exposure during pregnancies. Other studies on healthy blood donors showed frequency of alloimmunization from 0.05 to 4.0 per cent 4 5 6 7 8 9 10 11 . In our study, most frequent alloantibodies identified were of MNS blood group system.…”

“…The prevalence of red cell alloantibodies varies in males and females (multiple pregnancies) and individuals with past history of transfusion and/or transplant. Red cell alloantibodies have been found in up to four per cent of blood donors 4 5 6 7 8 9 10 11 . Among patient populations, the prevalence of alloantibodies has been reported to be 2-9 per cent in multitransfused patients and 9-40 per cent in sickle cell anaemia and thalassaemia patients 12 13 14 .…”

Prevalence of irregular red cell antibody in healthy blood donors attending a tertiary care hospital in North India

“…(0.05%). [ 14 15 ] This could be because of the fact that solid-phase testing has increased sensitivity and may detect weak autoantibodies that other method may miss. [ 12 ] As per our institutional policy, DAT-positive blood units were discarded.…”

Routine indirect antiglobulin testing of blood donors—a further step toward blood safety: an experience from a tertiary care center in northern India

“…In a similar study from a different transfusion center in the same region, 0.06 percent of the donors (4 of 6350) were found to be alloimmunized. 10 Studies from the national capital region of India quoted the incidence of unexpected antibodies among Indian donors to be in the range of 0.01 to 0.11 percent. 3,11,12 In our study, the most frequent alloantibodies identified were of the Lewis blood group system (17 of 25 [68%] in 14 of 19 alloimmunized donors), the second most common alloantibodies belonged to the Rh blood group system (4 of 25 [16%] in 3 of 19 alloimmunized donors), followed by those of the MNS blood group system (3 of 25 [12%] in 2 of 19 alloimmunized donors), and anti-K in one donor (1 of 25 [4%]).…”