Prevalence of erythrocyte alloimmunization in polytransfused patients

Objective: To determine the incidence and the rate of red blood cellalloimmunization in polytransfused patients. Methods: A polytransfusedpatient was defined as having received at least 6 units of red cellconcentrates during a 3-month period. The records of all patients(n = 12,904) who had received...

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Published inEinstein (São Paulo, Brazil) Vol. 9; no. 2; pp. 173 - 178
Main Authors Roberto de Oliveira Cruz, Mariza Aparecida Mota, Fabiana Mendes Conti, Ricardo Antônio d’Almeida Pereira, Jose Mauro Kutner, Maria Giselda Aravechia, Lilian Castilho
Format Journal Article
LanguageEnglish
Published Instituto Israelita de Ensino e Pesquisa Albert Einstein 01.06.2011
Subjects
Blood transfusion/adverse effects
Erythroblastosis
Erythrocytes/immunology
fetal
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Summary:Objective: To determine the incidence and the rate of red blood cellalloimmunization in polytransfused patients. Methods: A polytransfusedpatient was defined as having received at least 6 units of red cellconcentrates during a 3-month period. The records of all patients(n = 12,904) who had received red blood cell units were examinedretrospectively by searching the computer database at Hospital Israelita Albert Einstein in São Paulo, Brazil, over a 6-year period, between 2003 and 2009. Results: During this time, 77,049 red cell concentrate transfusions were performed in 12,904 patients. There were 3,044 polytransfused patients, 227 of whom (7.5%) presented with irregular erythrocyte antibodies. The prevalence of alloantibody specificity was: Anti-E>anti-D>anti-K>anti-C>anti-Dia>anti-c>anti-Jka>anti-S in 227 polytransfused patients. We found combinations of alloantibodies in 79 patients (34.8%), and the most common specificities were against the Rh and/or Kell systems. These antibodies show clinical significance, as they can cause delayed hemolytic transfusion reactions and perinatal hemolytic disease. About 20% of the patients showed an IgG autoantibody isolated or combined with alloantibodies. Interestingly, a high incidenceof antibodies against low frequency antigens was detected in thisstudy, mainly anti-Dia. Conclusion: Polytransfused patients have a high probability of developing alloantibodies whether alone or combined with autoantibodies and antibodies against low frequency antigens. Transfusion of red blood cells with a phenotype-compatible with RH (C, E, c), K, Fya, and Jka antigens is recommended for polytransfused patients in order to prevent alloimmunization and hemolytic transfusion reactions.
ISSN:1679-4508