Immunoprophylactic anti-Rho(D) treatment after mismatched transfusions

Ennker, J; Maas, D.; Schneider, Jonas

doi:10.1016/0028-2243(79)90009-1

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…Timely and appropriate doses of intramuscular RhIG can prevent alloimmunization to the D antigen in nearly 100 percent of D-recipients of D+ RBCs. [6][7][8] The use of intravenous RhIG has been approved by the Food and Drug Administration to treat children and adults with acute and chronic immune thrombocytopenia purpura and for suppression of D alloimmunization in pregnancy. The calculated dose of RhIG for the WinRho SDF™ product (WinRho SDF™, Cangene Corporation, Winnipeg, Canada) can be administered by either the intramuscular or intravenous route.…”

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confidence: 99%

Intravenous Rh immune globulin prevents alloimmunization in D– granulocyte recipients but obscures the detection of an alloanti-K

Stroncek¹,

Procter

Moses

et al. 2001

Immunohematology

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Rh immune globulin (RhIG) has been used to prevent alloimmunization in D– recipients of apheresis platelet transfusions from D+ donors that may contain up to 5 mL of D+ red blood cells (RBCs). Granulocyte concentrates contain approximately 30 mL of RBCs and it has been necessary to give D– recipients granulocyte transfusions from D+ donors. Intravenous RhIG has not yet been demonstrated to be effective in preventing D alloimmunization with granulocyte transfusions. Four D– recipients received multiple D+ granulocyte transfusions from D+ donors and multiple injections of intravenous RhIG at a standard dose of 600 μg for each D+ transfusion. Two D– males with chronic granulomatous disease were given 32 and 13 daily granulocyte transfusions, 18 and 2 of which, respectively, were D+. After the first dose of intravenous RhIG, both patients exhibited circulating anti-D that was undetectable 3 to 4 years later. Two patients with severe aplastic anemia were given 5 and 14 granulocyte transfusions, 4 and 7 of which, respectively, were D+. Both patients died before the effectiveness of RhIG could be assessed. In one of these patients the indirect and direct antiglobulin tests became positive after the first dose of intravenous RhIG, which required that subsequent granulocyte transfusions from D+ donors be crossmatched by immediate spin (IS) testing only. A delayed hemolytic reaction attributed to alloanti-K occurred after granulocytes from a K+ donor were given to this patient. These results suggest that intravenous RhIG can be used to prevent alloimmunization to D in D– patients receiving large quantities of RBCs from D+ granulocyte transfusions. However, anti-D and other passive antibodies from RhIG prohibit the use of the antiglobulin crossmatch with antigenpositive granulocyte donor samples. It may be important to frequently collect new samples to screen for newly formed alloantibodies when IS crossmatches are used in place of the antiglobulin crossmatch. Immunohematology 2001; 17:37–41.

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mentioning

confidence: 99%

Intravenous Rh immune globulin prevents alloimmunization in D– granulocyte recipients but obscures the detection of an alloanti-K

Stroncek¹,

Procter

Moses

et al. 2001

Immunohematology

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Passive anti‐C acquired in the setting of Rh immune globulin administration following Rh mismatched apheresis platelet transfusion: A case series

Sostin

Ross

Balbuena‐Merle

et al. 2020

J of Clinical Apheresis

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Rh immune globulin (RhIG) may be administered to Rh(D)‐negative recipients of Rh(D)‐positive platelet (PLT) transfusions to mitigate anti‐D alloantibody formation. We report a series of seven patients in which anti‐C was detected as a result of RhIG administered as immunoprophylaxis following Rh‐mismatched apheresis PLT transfusion, persisting for a range of 27 to 167 days post‐RhIG. The passively transferred anti‐C antibodies created complexities for subsequent transfusion support. Based on these challenges, in combination with emerging evidence supporting an extremely low anti‐D alloimmunization risk following Rh‐mismatched apheresis PLTs, we have changed our practice and now limit RhIG immunoprophylaxis in this setting to women of reproductive age. In summary, the blood bank and apheresis communities should be aware that passive transfer of non‐D antibodies is possible following RhIG administration. This phenomenon represents a compelling reason to consider the risk/benefit ratio of RhIG and to limit its use to situations in which it is clinically necessary.

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Isoimmunisation in pregnancy: diagnosis, treatment and prevention

Gravenhorst¹,

Woodfield²

1985

Supportive Therapy in Haematology

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Immunoprophylactic anti-Rho(D) treatment after mismatched transfusions

Cited by 3 publications

References 16 publications

Intravenous Rh immune globulin prevents alloimmunization in D– granulocyte recipients but obscures the detection of an alloanti-K

Intravenous Rh immune globulin prevents alloimmunization in D– granulocyte recipients but obscures the detection of an alloanti-K

Passive anti‐C acquired in the setting of Rh immune globulin administration following Rh mismatched apheresis platelet transfusion: A case series

Isoimmunisation in pregnancy: diagnosis, treatment and prevention

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