Safety assessment of RhD-positive red cell transfusion in RhD-negative liver-transplant recipients: Single-centre report from India

• Published in: Indian journal of medical research (New Delhi, India : 1994) Vol. 152; no. 6; pp. 662 - 666
• Main Authors: Tiwari, Aseem, Arora, Dinesh, Aggarwal, Geet, Dara, Ravi, Bhardwaj, Gunjan, Sharma, Jyoti, Vohra, Vijay, Soin, Arvinder
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.06.2020; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd
• Subjects: Blood transfusion; Erythrocytes; Health aspects; Humans; India - epidemiology; Isoantibodies; Liver; Liver Transplantation - adverse effects; Liver transplants; Living Donors; Methods; Retrospective Studies; Transplant Recipients; Transplantation; India; living donor liver transplants; transfusion; RhD-negative; Alloantibody; red blood cell
• ISSN: 0971-5916
• DOI: 10.4103/ijmr.IJMR_315_19

Background & objectives: The number of blood components required during a liver-transplant surgery is significant. It is challenging for blood transfusion services to provide the required RhD-negative red blood cells (RBCs) for recipients during the peri-operative period. This retrospective study presents safety data of transfusing RhD-positive RBCs in RhD-negative living donor liver-transplant (LDLT) recipients during the peri-operative period with six-month follow up for risk of developing alloantibodies. Methods: All RhD-negative patients who underwent LDLT and were transfused ABO-compatible but RhD-positive RBC units between January 2012 and May 2018 were included in the study. Twenty one RhD-negative patients who received a total of 167 RhD-positive RBCs peri-operatively were chosen for alloantibody screening. All the patients were started on triple immunosuppression drugs as per the standard hospital protocol. Blood grouping, cross-match and antibody screening were done by column agglutination technique. Results: Post-transplant antibody screen (weekly for 12 wk) was negative, and none of the patients developed anti-D alloantibodies till their last follow up (mean 21 months). Interpretation & conclusions: Our observations suggest that it may be safe to use RhD-positive RBCs peri-operatively in RhD-negative LDLT recipients with low risk of alloimmunization.