Prevalence and Haemolytic Significance of Red Cell Antibodies among Dangerous Universal Donors in a Tertiary Care Hospital in South India

Abstract

Background and Aims: A subgroup of group O individuals called ‘dangerous universal donors’ have immune (IgG) anti A and anti B antibodies which are active at 37˚C and capable of reacting with the red cells and causing lysis. The aim of this study was to find the prevalence of dangerous O group among the voluntary donor population and to assess the relation between the degree of haemolysis and the antibody titre. Materials and Methods: Group O donors excepting those with history of transfusion or pregnancy were included in the study. The serum samples were tested for haemolysins as per standard procedure. The degree of haemolysis was graded and strongly haemolytic samples were further characterised for the type of immunoglobulin class after treatment with dithiothretiol. The results were coded and analysed using SPSS software. Results: The age of the donors in this study ranged from 18 to 56 years. Majority were males. The prevalence of dangerous O group in our study population was found to be 10.75%. Within the dangerous O group samples, the titre of anti B IgG antibody was found to be higher than anti A IgG antibody. Titres for both anti A and anti B IgG antibodies ranged from 1:2 to 1:64. Conclusions: A simple screening for donor haemolysins will help in identification of strongly haemolytic samples, which are likely to have high titres of IgG, particularly anti A antibody. This will prevent transfusion of blood containing high titres of immune anti A and anti B antibodies to non O group recipients.

Prevalence of alpha and beta haemolysin among blood group O donors in Bamenda, Cameroon

“…25 The high prevalence of haemolysin in this study is comparable to that (52.8%) reported by a study in Abakaliki, Nigeria, in 2014. 25 Lower haemolysin prevalence rates have been reported by studies among healthy blood donors in South India (10.8% in 2019), 26 Abidjan, Côte d’lvoire 18 (35.1% in 2016), Lagos, Nigeria 10 (30.3% in 2015), Bauchi, Nigeria 27 (22.2% in 2015), Anambra, Nigeria 28 (16.06% in 2015), Tunisia 14 (6.6% in 2008), Ilorin, Nigeria 11 (23.2% in 2001), and Nigeria 12 (30.6% in 1990). A higher prevalence of 69.0% was reported in a 2012 study on healthy blood donors in Bangkok, Thailand.…”

“…A higher prevalence of 69.0% was reported in a 2012 study on healthy blood donors in Bangkok, Thailand. 29 These differences in prevalence rates may be due to the admixture of blood of immigrants as a result of intermarriages, 20 variations in serum-cell ratios, 30 or differences in geographical location, 26 particularly due to the differences in the degree of exposure to gastrointestinal parasites 22 and mosquitoes. 13 , 14 , 15 It has been reported that higher serum-cell ratios increase the tendency for red cell lysis.…”

“…22 Our observation is lower than those reported by studies conducted among blood group O donors in Lagos, Nigeria, in 2015 (18.6%) 10 and Ilorin, Nigeria, in 2021 (31.7%). 11 This may be due to differences in geographical location 26 and the degree of exposure to gastrointestinal parasites 22 and mosquitoes. 13 , 14 , 15…”

Screening and Titration of Anti-A and Anti-B Haemolysins in Blood Donors: An Essential Test for Transfusion Immunosafety of Packed Red Blood Cells

“…Group A donors followed with a rate of 11.4%, while group B donors accounted for 5.9% of cases. This observation explains why most studies on haemolysins have focused mainly on group O donors [10][11][12][13][14][15][16][17][18]22]. The predominance of group O is explained by their high frequency in the world population and by the absence of A and B antigens on the surface of their red blood cells.…”

“…This is particularly useful in emergency situations where blood grouping could delay medical treatment or where there is a shortage of isogroup blood [1][2][3][4][5]. It is important to note, however, that for group Of individuals with ABO haemolysins, their blood must be reserved for isogroup transfusions because of the risk of incompatibility [1], hence their occasional nickname of "dangerous universal donors" in such circumstances [22]. We also found differences in the prevalence of different haemolysin specificities according to blood group.…”