The development and evanescence of red blood cell antibodies in a 51-year-old pregnant ovum recipient and her pregnancy outcome

• Published in: Transfusion and apheresis science Vol. 64; no. 4; p. 104204
• Main Authors: Xu, Wenhao, Chang, Chunkang
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2025
• Subjects: Alloimmunization; Antibody evanescence; Erythroblastosis, Fetal - therapy; Erythrocytes - immunology; Female; Hematology, Oncology, and Palliative Medicine; Hemolytic disease of the fetus and newborn; Humans; Infant, Newborn; Isoantibodies - blood; Isoantibodies - immunology; Middle Aged; Pregnancy; Pregnancy Outcome; Pregnancy woman; Transfusion; Hemolytic disease of the fetus and newborn; Antibody evanescence; Transfusion; Pregnancy woman; Alloimmunization
• ISSN: 1473-0502
• DOI: 10.1016/j.transci.2025.104204

Management of complications, including hemolytic disease of the fetus and newborn (HDFN) and identifying compatible red blood cell (RBC) for future transfusions, related to multiple RBC alloantibodies in extremely advanced age pregnant donor ovum (DO) recipient is a challenge for transfusion medicine, especially during emergencies when alloantibodies become evanescent. Here we reported a 51-year-old woman underwent three cycles of IVF using embryos from her husband sperm and anonymously DO. She was detected with anti-Ce and anti-Jka alloantibodies during the pregnancy, with anti-Jka becoming evanescent in the third trimester and reinduced after delivery. She had a postpartum hemorrhage of 1200 ml blood loss and transfused 2 units of 800 ml Rh and Kidd compatible RBC screened by Shanghai Blood Center. The newborn experienced moderate HDFN and was treated with phototherapy and intravenous immune globulin. •Maternal RBC alloantibody may be evanescence during pregnancy.•Maternal with donor ovum recipient can increase the risk of HDFN.•Emergency blood preparation for maternal with complicated alloantibodies is a challenge.