Recurrent acute hemolytic transfusion reactions by antibodies against Do a antigens, not detected by cross‐matching

• Published in: Transfusion (Philadelphia, Pa.) Vol. 46; no. 2; pp. 244 - 249
• Main Authors: Baumgarten, Ruben, Van Gelder, Warry, Van Wintershoven, Joyce, Maaskant‐Van Wijk, Petra A., Beckers, Erik A.M.
• Format: Journal Article
• Language: English
• Published: 01.02.2006
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/j.1537-2995.2006.00707.x

An 81‐year‐old male patient suffered from recurrent acute hemolytic transfusion reactions after transfusion with phenotyped cross‐match‐negative red blood cells (RBCs). Extensive posttransfusion workup eventually revealed Dombrock (a) (Do a ) antibodies. Because commercially available cell panels do not allow for identification of anti‐Do a and owing to the lack of Do a typing serum samples, selection of matched units of RBCs is dependent on negative cross‐match results. In this case, selection of Do(a–) units by cross‐matching failed, indicating that serologic methods were not reliable. A polymerase chain reaction with sequence‐specific priming assay was used to detect DOA and DOB alleles, which encode Do a and Do b antigens, respectively. The patient was confirmed to be DOB/DOB by DNA sequencing. Furthermore, the involved mismatched units in each of the three hemolytic episodes were shown to be Do(a+). In the presenting case, DNA typing appeared to be superior to serologic methods in selecting matched RBC units in the presence of anti‐Do a .