Red cell alloimmunization in multi-transfused chronic renal failure patients undergoing hemodialysis

Red blood cell (RBC) transfusions are frequently used in the management of patients with chronic renal failure (CRF) undergoing hemodialysis for dialysis-related anaemia. Consequently, they are subject to all hazards associated with repeated transfusions, such as red cell alloimmunization. A retrospective study was performed to estimate the frequency of alloimmunization against red cell antigens in multitransfused CRF patients. A total of 81 patients (67 males & 14 females) with CRF were studied who received a mean of 8.5 units of RBC matched for ABO & Rh(D) antigens only. Using standard techniques (indirect antiglobulin test, enzyme, polyethylene glycol, and low ionic strength solution), we observed a RBC alloimmunization rate of 9.8% (8/81). Nine alloantibodies were detected in 8 patients, and most (88%) involved antigens in the Rhesus & Kell systems. No correlation was observed with the alloantibody formation & number of units transfused. The calculated risk of 1.3% observed in the present study, suggests that renal failure patients are not at a higher risk of red cell alloimmunization than the general population.