Red Cells, HLA and Platelet Antibody Formation in Patients with Multiple Transfusions

Abstract

Totally 436 Chinese patients having received multiple transfusions of red cells and platelets on more than three occasions were screened for red cell antibodies. Twenty-six (6%) of them were positive. Anti-E, -Mia, and -c were the common alloantibodies. Nine patients were immunized during the period of regular transfusions, with a newly immunized rate of 2% (9/436). Among 436 patients, 387 were screened for HLA antibodies by lymphocytotoxicity test (LCT). The overall positive rate was 35%. Most of the antibodies identified were against the high-frequency HLA antigens in the Chinese population. About 10% of the LCT-positive cases reverted to negative state during the follow-up period. After chloroquine stripping of the target platelets, mixed passive hemagglutination assay was used to detect platelet antibodies other than HLA antibody. Fifty-eight of 161 cases (36%) were positive for platelet antibodies, but half of them disappeared within 1 month. Nineteen of the 58 patients had sepsis and 2 had jaundice. These findings suggested that HLA and platelet antibodies are common among Chinese, though their clinical significance and the role in platelet damage are doubtful.

Red cell alloimmunization in repeatedly transfused patients

“…In the present study, rate of alloimmunization was consistent with other studies done internationally[ 4 5 6 ] and various studies from India [ Table 3 ]. [ 3 7 9 11 ]…”

Alloimmunization after blood transfusion in patients with hematologic and oncologic diseases

“…Several authors 2,4,12,17,18 reported comparable results for the risk and the number of transfusions. There are also studies that found higher 1,6,11,22 and lower 16,19,30,33–35 immunization rates. Factors such as the patient population under study, the transfusion policy, the time and frequency of testing, the sensitivity of the test methods, and the technical expertise of the transfusion laboratory staff play an important role in the difference in results obtained.…”

Post-transfusion red cell alloimmunisation in patients with acute disorders and medical emergencies

“…Especially for patients prone to receive multiple transfusions, compatibility for red cell antigens must include ABO, Rh as well as minor antigens, although the majority of haemolytic transfusion reactions are due to a limited number of alloantibodies. 11 Antibodies against highfrequency antigens can hinder obtaining suitable blood units and a lack of phenotypic compatibility between donor and recipient blood may result in potential life-threatening complications.…”