Immune Response to Chronic Red Blood Cell Transfusion

Blumberg, Neil; Peck, Kathy; Ross, Karen C.; Avila, Eduardo

doi:10.1111/j.1423-0410.1983.tb01886.x

Cited by 78 publications

(53 citation statements)

References 14 publications

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“…Blumberg et al ,[7] studied patients with disorders that often lead to repetitive transfusions and the frequency of red cell antibodies was about 3% overall. In a study by Domen and Ramirez et al ,[1] incidence of alloimmunization in chronic renal disease patients on hemodialysis was found to be 6.1%.…”

Section: Discussionmentioning

confidence: 99%

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Detection of alloimmunization to ensure safer transfusion practice

Sood

Makroo

Riana

et al. 2013

Asian J Transfus Sci

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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.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies reporting low rate of alloimmunization (5 to 10%) include those by Chaudhary et al ,[10] Blumberg et al ,[7] and Hmida et al . [9] A high rate of approximately 20% was noted in studies by Spanos et al ,[8] Michail-Merianou et al ,[12] Singer et al ,[13] and Ameen et al .…”

Section: Discussionmentioning

confidence: 99%

Detection of alloimmunization to ensure safer transfusion practice

Sood

Makroo

Riana

et al. 2013

Asian J Transfus Sci

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“…However, female patients were reported not to be a majority once. [15] The ethnic distribution of alloantibodies indicates that Malays are predominantly affected, which is attributable to the fact that Kelantan State is populated by a great majority of Malays. Also expected, patients who had experienced blood transfusions were found to be more liable to developing alloantibodies than those who never experienced a blood transfusion.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and specificities of red cell alloantibodies among blood recipients in the Malaysian state of Kelantan

Al-Joudi

Ali

Ramli

et al. 2011

Asian J Transfus Sci

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Background:Red blood cell (RBC) alloantibodies may be formed following exposure to RBC antigens. In most cases, the alloimmunization develops during pregnancy or from previous blood transfusions. The RBC antigens and their alloantibodies vary among different human populations and ethnic groups, and they do have a clinical significance for their adverse immunological reactions.Aims:This study aimed at studying the prevalence of RBC alloantibodies at the Blood Transfusion Unit of Hospital Raja Perempuan Zainab II in Kota Bharu, Malaysia.Patients and Methods:A cross-sectional study was performed utilizing data obtained in the years 2007 and 2008. Data of antibody screening tests from 5719 patients were examined.Results and Discussion:The overall prevalence of alloimmunization was 65 (1.13%). The majority of these had a single alloantibody (76.9%), whereas the remaining 23.1% had multiple antibodies. The anti-E antibody comprised the most common alloantibody (24.6%) followed by the anti-Lewis (a) antibodies (18.5%) and the anti-M antibody (13.8%). There were more female recipients than males.Conclusions:It was concluded that the findings of this work have been comparable with other published works, and that the main factors associated with alloantibody formation were multiple transfusions and pregnancies. The study also emphasizes the necessity for carrying out immunohematology studies prior to every blood transfusion especially in cases that require multiple transfusions for a long period of time such as in thalassemia patients.

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“…Hence, transfusion exposes recipients to numerous RBC alloantigens, including Kell, Duffy, and Kidd, which induce formation of Ag-specific IgG alloantibodies in 3–10% of all recipients and as many as 30–50% of transfusion-dependent patients with sickle cell disease (1–7). Such responses can cause potentially fatal hemolytic transfusion reactions (8, 9).…”

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confidence: 99%

Type I IFN Is Necessary and Sufficient for Inflammation-Induced Red Blood Cell Alloimmunization in Mice

Gibb

Liu

Natarajan

et al. 2017

The Journal of Immunology

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During RBC transfusion, production of alloantibodies against RBC non-ABO Ags can cause hemolytic transfusion reactions and limit availability of compatible blood products, resulting in anemia-associated morbidity and mortality. Multiple studies have established that certain inflammatory disorders and inflammatory stimuli promote alloimmune responses to RBC Ags. However, the molecular mechanisms underlying these findings are poorly understood. Type I IFNs (IFN-α/β) are induced in inflammatory conditions associated with increased alloimmunization. By developing a new transgenic murine model, we demonstrate that signaling through the IFN-α/β receptor is required for inflammation-induced alloimmunization. Additionally, mitochondrial antiviral signaling protein—mediated signaling through cytosolic pattern recognition receptors was required for polyinosinic-polycytidylic acid—induced IFN-α/β production and alloimmunization. We further report that IFN-α, in the absence of an adjuvant, is sufficient to induce RBC alloimmunization. These findings raise the possibility that patients with IFN-α/β—mediated conditions, including autoimmunity and viral infections, may have an increased risk of RBC alloimmunization and may benefit from personalized transfusion protocols and/or targeted therapies.

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Immune Response to Chronic Red Blood Cell Transfusion

Cited by 78 publications

References 14 publications

Detection of alloimmunization to ensure safer transfusion practice

Detection of alloimmunization to ensure safer transfusion practice

Prevalence and specificities of red cell alloantibodies among blood recipients in the Malaysian state of Kelantan

Type I IFN Is Necessary and Sufficient for Inflammation-Induced Red Blood Cell Alloimmunization in Mice

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