Rh(D) IMMUNIZATION AFTER MASSIVE TRANSFUSION OF Rh(D)–POSITIVE BLOOD

Absence of D alloimmunization in D– pediatric oncology patients receiving D‐incompatible single‐donor platelets

“…D– patients treated with cyclosporine and corticosteroids undergoing liver or heart transplant surgery had a frequency of primary alloimmunization of 1 in 17 after receiving one or more units of D+ RBCs 12 . In contrast, nonimmunosupressed D– patients receiving massive D‐incompatible RBC transfusions during heart surgery had a 95‐percent incidence rate of alloimmunization 13 …”

“…12 In contrast, nonimmunosupressed D-patients receiving massive D-incompatible RBC transfusions during heart surgery had a 95-percent incidence rate of alloimmunization. 13 The minimal quantity of RBCs capable of alloimmunizing the potentially immunosupressed oncology patient is not known. The few studies available that analyze the immunogenicity of D-incompatible platelets in this population have produced conflicting results.…”

A case for stocking O D+ red blood cells in emergency room trauma bays

“…Pollack and colleagues transfused 500 mL of D+ blood to 22 D− healthy volunteers and found the rate of alloimmunization to be 81.8% (18 of 22). Cook and Rush in 1974 found in 20 D− patients transfused an average of 19.4 D+ units per patient an alloimmunization rate of 95% (19/20). Yazer and Triulzi retrospectively reviewed the transfusion records of 15 hospitals and found 98 D− patients received 445 D+ RBC units.…”

Frozen Red Cells in Rhesus Immunization

“…The use of large volumes of red cells (500 ml) was shown by Pollack et a1 (1971) to give an 82% response, and Cook & Rush (1974) in Australia have confirmed a similar high response following massive transfusion of Rh positive blood in open heart surgery, where 19 out of 20 Rh negative subjects (95%) developed anti-D. A similar response to a 200 ml primary dose of red cell concentrate (93%) in Group I1 (Table 11) by the Edinburgh male volunteers shows that the antigenity of different genotypes is not so relevant when a massive primary dose is used. The main advantages of this method are that fewer male volunteers will need to be placed 'at risk' and the search for suitable cell donors does not need to be restricted to those with an Rz antigenic complex.…”